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Hypersensitivity Dermatitis and Hepatitis

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Trichloroethylene: Toxicity and Health Risks

Part of the book series: Molecular and Integrative Toxicology ((MOLECUL))

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Abstract

Occupational exposure to trichloroethylene (TCE) rarely induces severe generalized hypersensitivity dermatitis accompanying grave hepatitis, referred to as occupational TCE hypersensitivity syndrome (HS), in susceptible workers. TCE HS resembles delayed-type severe cutaneous adverse reactions to drugs and is totally different from solvent-induced irritating contact dermatitis. Importantly, human herpesvirus 6, which remains latent within the body after primary infection during infancy, is reactivated in most patients, and the reactivation affects the clinical course of this disease. Lines of evidence have established the current notion that TCE has sensitization potency. Though human leucocyte antigen (HLA)-B*13:01 has been identified as a marker of individual susceptibility, appropriate occupational hygiene practices to reduce the exposure and the biological monitoring of urinary TCE metabolites can be crucial to preventing this disease. Since the causal relationship between TCE exposure and this life-threatening occupational disease can be overlooked, the disease needs special attention from occupational health professionals and clinicians.

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References

  • Agency for Toxic Substances and Disease Registry (1997) Toxicological profile for trichloroethylene. U.S. Department of Health and Human Services, Atlanta

    Google Scholar 

  • American Conference of Governmental Industrial Hygienists (2007) Trichloroethylene. In: TLVs and BEIs 2007, Cincinnati: ACGIH.

    Google Scholar 

  • Asano Y, Yoshikawa T, Suga S, Yazaki T, Hata T, Nagai T, Kajita Y, Ozaki T, Yoshida S (1989) Viremia and neutralizing antibody response in infants with exanthem subitum. J Pediatr 114:535–539

    Article  CAS  PubMed  Google Scholar 

  • Bassig BA, Zhang L, Tang X, Vermeulen R, Shen M, Smith MT, Qiu C, Ge Y, Ji Z, Reiss B, Hosgood HD 3rd, Liu S, Bagni R, Guo W, Purdue M, Hu W, Yue F, Li L, Huang H, Rothman N, Lan Q (2013) Occupational exposure to trichloroethylene and serum concentrations of IL-6, IL-10, and TNF-alpha. Environ Mol Mutagen 54:450–454

    Article  CAS  PubMed  Google Scholar 

  • Bauer M, Rabens SF (1974) Cutaneous manifestations of trichloroethylene toxicity. Arch Dermatol 110:886–890

    Article  CAS  PubMed  Google Scholar 

  • Bond GR (1996) Hepatitis, rash and eosinophilia following trichloroethylene exposure: a case report and speculation on mechanistic similarity to halothane induced hepatitis. J Toxicol Clin Toxicol 34:461–466

    Article  CAS  PubMed  Google Scholar 

  • Chittasobhaktra T, Wannanukul W, Wattanakrai P, Pramoolsinsap C, Sohonslitdsuk A, Nitiyanant P (1997) Fever, skin rash, jaundice and lymphadenopathy after trichloroethylene exposure: a case report. J Med Assoc Thai 80 Suppl 1:S144–S148

    CAS  PubMed  Google Scholar 

  • Chung WH, Hung SI, Hong HS, Hsih MS, Yang LC, Ho HC, Wu JY, Chen YT (2004) Medical genetics: a marker for Stevens-Johnson syndrome. Nature 428:486

    Article  CAS  PubMed  Google Scholar 

  • Conde-Salazar L, Guimaraens D, Romero LV, Sanchez YE (1983) Subcorneal pustular eruption and erythema from occupational exposure to trichloroethylene. Contact Dermatitis 9:235–237

    Article  CAS  PubMed  Google Scholar 

  • Dai Y, Leng S, Li L, Niu Y, Huang H, Cheng J, Zheng Y (2004) Genetic polymorphisms of cytokine genes and risk for trichloroethylene-induced severe generalized dermatitis: a case-control study. Biomarkers 9:470–478

    Article  CAS  PubMed  Google Scholar 

  • Dai Y, Leng S, Li L, Niu Y, Huang H, Liu Q, Duan H, Cheng J, Zheng Y (2009) Effects of genetic polymorphisms of N-acetyltransferase on trichloroethylene-induced hypersensitivity dermatitis among exposed workers. Ind Health 47:479–486

    Article  CAS  PubMed  Google Scholar 

  • Estrella-Gust D, Cucueco M, Granadillos N, Dumayag C (1999) Outbreak of Stevens-Johnson syndrome (SJS) in an electronics company in the Philippines. In: Proceeding of 16th Asian conference on occupational health. Cebu

    Google Scholar 

  • Flamand L, Gosselin J, D’Addario M, Hiscott J, Ablashi DV, Gallo RC, Menezes J (1991) Human herpesvirus 6 induces interleukin-1 beta and tumor necrosis factor alpha, but not interleukin-6, in peripheral blood mononuclear cell cultures. J Virol 65:5105–5110

    CAS  PubMed Central  PubMed  Google Scholar 

  • Goh CL, Ng SK (1988) A cutaneous manifestation of trichloroethylene toxicity. Contact Dermatitis 18:59–61

    Article  CAS  PubMed  Google Scholar 

  • Goon AT, Lee LT, Tay YK, Yosipovitch G, Ng SK, Giam YC (2001) A case of trichloroethylene hypersensitivity syndrome. Arch Dermatol 137:274–276

    CAS  PubMed  Google Scholar 

  • Hashimoto K, Yasukawa M, Tohyama M (2003) Human herpesvirus 6 and drug allergy. Curr Opin Allergy Clin Immunol 3:255–260

    Article  CAS  PubMed  Google Scholar 

  • Hisanaga N, Jonai H, Yu X, Ogawa Y, Mori I, Kamijima M, Ichihara G, Shibata E, Takeuchi Y (2002) Stevens-Johnson syndrome accompanied by acute hepatitis in workers exposed to trichloroethylene or tetrachloroethylene. Sangyo Eiseigaku Zasshi 44:33–49 (In Japanese with English abstract)

    CAS  PubMed  Google Scholar 

  • Huang HL, Li LY, Chen BJ, Huang JX, Kuang SR (2002) New problems caused by occupational trichloroethylene exposure. Int J Immunopathol Pharmacol 15:30–32

    Google Scholar 

  • Huang H, Kamijima M, Wang H, Li S, Yoshikawa T, Lai G, Huang Z, Liu H, Chen J, Takeuchi Y, Nakajima T, Li L (2006) Human herpesvirus 6 reactivation in trichloroethylene-exposed workers suffering from generalized skin disorders accompanied by hepatic dysfunction. J Occup Health 48:417–423

    Article  CAS  PubMed  Google Scholar 

  • Hung SI, Chung WH, Liou LB, Chu CC, Lin M, Huang HP, Lin YL, Lan JL, Yang LC, Hong HS, Chen MJ, Lai PC, Wu MS, Chu CY, Wang KH, Chen CH, Fann CS, Wu JY, Chen YT (2005) HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol. Proc Natl Acad Sci U S A 102:4134–4139

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Iavicoli I, Marinaccio A, Carelli G (2005) Effects of occupational trichloroethylene exposure on cytokine levels in workers. J Occup Environ Med 47:453–457

    Article  CAS  PubMed  Google Scholar 

  • Ikeda M, Imamura T (1973) Biological half-life of trichloroethylene and tetrachloroethylene in human subjects. Int Arch Arbeitsmed 31:209–224

    Article  CAS  PubMed  Google Scholar 

  • Ikeoka T, Saito T, Hosaka Y, Takahara N, Suzuki R, Fukushima T, Sato T, Oshima H, Kuramochi S, Chong T (2009) Drug-induced hypersensitivity syndrome caused by trichloroethylene exposure. J Jpn Soc Int Med 98:1120–1123 (In Japanese)

    Article  Google Scholar 

  • Ito Y, Kamijima M, Yanagiba Y, Okamura A, Yamanoshita O, Nakajima T (2007) Generalized skin disorders and accompanying hepatitis in trichloroethylene-exposed workers: 2nd report – relationship between HHV-6 reaction and changes of serum or plasma cytokines. Sangyo Eiseigaku Zasshi 49(Suppl):426 (In Japanese)

    Google Scholar 

  • Jia Q, Zang D, Yi J, Dong H, Niu Y, Zhai Q, Teng Y, Bin P, Zhou W, Huang X, Li H, Zheng Y, Dai Y (2012) Cytokine expression in trichloroethylene-induced hypersensitivity dermatitis: an in vivo and in vitro study. Toxicol Lett 215:31–39

    Article  CAS  PubMed  Google Scholar 

  • Jung HG, Kim HH, Song BG, Kim EJ (2012) Trichloroethylene hypersensitivity syndrome: a disease of fatal outcome. Yonsei Med J 53:231–235

    Article  PubMed Central  PubMed  Google Scholar 

  • Kamijima M, Hisanaga N, Wang H, Nakajima T (2007) Occupational trichloroethylene exposure as a cause of idiosyncratic generalized skin disorders and accompanying hepatitis similar to drug hypersensitivities. Int Arch Occup Environ Health 80:357–370

    Article  CAS  PubMed  Google Scholar 

  • Kamijima M, Wang H, Huang H, Li L, Shibata E, Lin B, Sakai K, Liu H, Tsuchiyama F, Chen J, Okamura A, Huang X, Hisanaga N, Huang Z, Ito Y, Takeuchi Y, Nakajima T (2008) Trichloroethylene causes generalized hypersensitivity skin disorders complicated by hepatitis. J Occup Health 50:328–338

    Article  CAS  PubMed  Google Scholar 

  • Kamijima M, Wang H, Yamanoshita O, Ito Y, Xia L, Yanagiba Y, Okamura A, Huang Z, Qiu X, Song X, Cai T, Liu L, Ge Y, Deng Y, Naito H, Yoshikawa T, Tohyama M, Li L, Huang H, Nakajima T (2013) Occupational trichloroethylene hypersensitivity syndrome: human herpesvirus 6 reactivation and rash phenotypes. J Dermatol Sci 72:218–224

    Article  CAS  PubMed  Google Scholar 

  • Kimber I, Basketter DA, Gerberick GF, Dearman RJ (2002) Allergic contact dermatitis. Int Immunopharmacol 2:201–211

    Article  CAS  PubMed  Google Scholar 

  • Li HS, Dai YF, Huang HL, Sun YF (2006) Polymorphisms of aldehyde and alcohol dehydrogenase genes associated with susceptibility to trichloroethylene-induced medicamentosa-like dermatitis. Wei Sheng Yan Jiu 35:149–151 (in Chinese)

    CAS  PubMed  Google Scholar 

  • Li H, Dai Y, Huang H, Li L, Leng S, Cheng J, Niu Y, Duan H, Liu Q, Zhang X, Huang X, Xie J, Feng Z, Wang J, He J, Zheng Y (2007) HLA-B*1301 as a biomarker for genetic susceptibility to hypersensitivity dermatitis induced by trichloroethylene among workers in China. Environ Health Perspect 115:1553–1556

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Lin B, Chen S, Wang D (2003) An investigation on three factories with consecutive occurrences of trichloroethylene-induced medicamentosa-like dermatitis. Chin Occup Med 30:65–66 (in Chinese)

    Google Scholar 

  • Lindner K, Prater E, Schubert H, Siegmund S (1990) Drug exanthema due to chloral hydrate. Dermatol Monatsschr 176:483–485 (in German with English abstract)

    CAS  PubMed  Google Scholar 

  • Ministry of Health of the People’s Republic of China. Diagnostic criteria of occupational medicamentose-like dermatitis due to trichloroethylene. National Occupational Health Standard GBZ 185–2006 of P.R. of China: 2007. (In Chinese)

    Google Scholar 

  • Mohr TK (2001) Solvent stabilizers: white paper. Santa Clara Valley Water District, San Jose, p 55

    Google Scholar 

  • Nakajima T, Okino T, Okuyama S, Kaneko T, Yonekura I, Sato A (1988) Ethanol-induced enhancement of trichloroethylene metabolism and hepatotoxicity: difference from the effect of phenobarbital. Toxicol Appl Pharmacol 94:227–237

    Article  CAS  PubMed  Google Scholar 

  • Nakajima T, Yamanoshita O, Kamijima M, Kishi R, Ichihara G (2003) Generalized skin reactions in relation to trichloroethylene exposure: a review from the viewpoint of drug-metabolizing enzymes. J Occup Health 45:8–14

    Article  CAS  PubMed  Google Scholar 

  • Nakayama H, Kobayashi M, Takahashi M, Ageishi Y, Takano T (1988) Generalized eruption with severe liver dysfunction associated with occupational exposure to trichloroethylene. Contact Dermatitis 19:48–51

    Article  CAS  PubMed  Google Scholar 

  • Okamura A, Kamijima M, Ito Y, Yanagiba Y, Yamanoshita O, Wang H, Huang H, Li L, Yoshikawa T, Nakajima T (2007) Generalized skin disorders and accompanying hepatitis intrichloroethylene-exposed workers: 1st report – course of blood cytokine concentrations after occurrence of the disorders. Sangyo Eiseigaku Zasshi 49(Suppl):425 (In Japanese)

    Google Scholar 

  • Pantucharoensri S, Boontee P, Likhitsan P, Padungtod C, Prasartsansoui S (2004) Generalized eruption accompanied by hepatitis in two Thai metal cleaners exposed to trichloroethylene. Ind Health 42:385–388

    Article  PubMed  Google Scholar 

  • Phoon WH, Chan MO, Rajan VS, Tan KJ, Thirumoorthy T, Goh CL (1984) Stevens-Johnson syndrome associated with occupational exposure to trichloroethylene. Contact Dermatitis 10:270–276

    Article  CAS  PubMed  Google Scholar 

  • Ramdhan DH, Kamijima M, Yamada N, Ito Y, Yanagiba Y, Nakamura D, Okamura A, Ichihara G, Aoyama T, Gonzalez FJ, Nakajima T (2008) Molecular mechanism of trichloroethylene-induced hepatotoxicity mediated by CYP2E1. Toxicol Appl Pharmacol 231:300–307

    Article  CAS  PubMed  Google Scholar 

  • Ramdhan DH, Kamijima M, Wang D, Ito Y, Naito H, Yanagiba Y, Hayashi Y, Tanaka N, Aoyama T, Gonzalez FJ, Nakajima T (2010) Differential response to trichloroethylene-induced hepatosteatosis in wild-type and PPARalpha-humanized mice. Environ Health Perspect 118:1557–1563

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Schwartz L, Tulipan L, Birmingham DJ (1947) Analysis of skin hazards in various occupations. In: Occupational diseases of the skin. Lea and Febiger, Philadelphia, p 771

    Google Scholar 

  • Shiohara T, Inaoka M, Kano Y (2006) Drug-induced hypersensitivity syndrome (DIHS): a reaction induced by a complex interplay among herpesviruses and antiviral and antidrug immune responses. Allergol Int 55:1–8

    Article  PubMed  Google Scholar 

  • Shiohara T, Iijima M, Ikezawa Z, Hashimoto K (2007) The diagnosis of a DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations. Br J Dermatol 156:1083–1084

    Article  CAS  PubMed  Google Scholar 

  • Tan HH, Tsu-Li Chan M, Goh CL (1997) Occupational skin disease in workers from the electronics industry in Singapore. Am J Contact Dermat 8:210–214

    Article  CAS  PubMed  Google Scholar 

  • Tang XJ, Li LY, Huang JX, Deng YY (2002) Guinea pig maximization test for trichloroethylene and its metabolites. Biomed Environ Sci 15:113–118

    PubMed  Google Scholar 

  • Tang X, Que B, Song X, Li S, Yang X, Wang H, Huang H, Kamijima M, Nakajima T, Lin Y, Li L (2008) Characterization of liver injury associated with hypersensitive skin reactions induced by trichloroethylene in the guinea pig maximization test. J Occup Health 50:114–121

    Article  CAS  PubMed  Google Scholar 

  • Tohyama M, Hashimoto K, Yasukawa M, Kimura H, Horikawa T, Nakajima K, Urano Y, Matsumoto K, Iijima M, Shear NH (2007) Association of human herpesvirus 6 reactivation with the flaring and severity of drug-induced hypersensitivity syndrome. Br J Dermatol 157:934–940

    Article  CAS  PubMed  Google Scholar 

  • Wahlberg JE, Adams RM (1999) Solvents. In: Adams RM (ed) Occupational skin disease. W.B. Saunders, Philadelphia, pp 484–500

    Google Scholar 

  • Watanabe H (2011) Hypersensitivity syndrome due to trichloroethylene exposure: a severe generalized skin reaction resembling drug-induced hypersensitivity syndrome. J Dermatol 38:229–235

    Article  CAS  PubMed  Google Scholar 

  • Watanabe H, Tohyama M, Kamijima M, Nakajima T, Yoshida T, Hashimoto K, Iijima M (2010) Occupational trichloroethylene hypersensitivity syndrome with human herpesvirus-6 and cytomegalovirus reactivation. Dermatology 221:17–22

    Article  PubMed  Google Scholar 

  • World Health Organization (WHO) (1985) Environmental health criteria 50. Trichloroethylene. World Health Organization, Geneva

    Google Scholar 

  • Yamanishi K, Okuno T, Shiraki K, Takahashi M, Kondo T, Asano Y, Kurata T (1988) Identification of human herpesvirus-6 as a causal agent for exanthem subitum. Lancet 1:1065–1067

    Article  CAS  PubMed  Google Scholar 

  • Yanagiba Y: Generalized skin disorders and accompanying hepatitis in trichloroethylene-exposed workers. 3rd report. the relation between HHV6 genotype and HHV7. Sangyo Eiseigaku Zasshi. 49(Suppl): 427, 2007 (In Japanese)

    Google Scholar 

  • Yoshikawa T, Suga S, Asano Y, Yazaki T, Kodama H, Ozaki T (1989) Distribution of antibodies to a causative agent of exanthem subitum (human herpesvirus-6) in healthy individuals. Pediatrics 84:675–677

    CAS  PubMed  Google Scholar 

  • Yoshikawa T, Fujita A, Yagami A, Suzuki K, Matsunaga K, Ihira M, Asano Y (2006) Human herpesvirus 6 reactivation and inflammatory cytokine production in patients with drug-induced hypersensitivity syndrome. J Clin Virol 37 Suppl 1:S92–S96

    Article  PubMed  Google Scholar 

  • Zhang J, Yang H, Li H, Liu F, Jia Q, Duan H, Niu Y, Bin P, Zheng Y, Dai Y (2013) Peptide-binding motifs and characteristics for HLA -B*13:01 molecule. Tissue Antigens 81:442–448

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, 4678601, Mizuho-ku, Nagoya, Japan

    Michihiro Kamijima & Yuki Ito

  2. Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, P.R. of China

    Hailan Wang

  3. Chubu University College of Life and Health Sciences, Kasugai, Japan

    Osamu Yamanoshita & Tamie Nakajima

Authors
  1. Michihiro Kamijima
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  2. Hailan Wang
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  3. Osamu Yamanoshita
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  4. Yuki Ito
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  5. Tamie Nakajima
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Editors and Affiliations

  1. Department of Microbiology and Immunology, Arkansas Children’s Hospital Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Kathleen M. Gilbert

  2. Department of Pediatrics, Arkansas Children’s Hospital Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Sarah J. Blossom

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Kamijima, M., Wang, H., Yamanoshita, O., Ito, Y., Nakajima, T. (2014). Hypersensitivity Dermatitis and Hepatitis. In: Gilbert, K., Blossom, S. (eds) Trichloroethylene: Toxicity and Health Risks. Molecular and Integrative Toxicology. Springer, London. https://doi.org/10.1007/978-1-4471-6311-4_3

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