J Korean Med Sci.  2018 Apr;33(14):e106. 10.3346/jkms.2018.33.e106.

Trichloroethylene Hypersensitivity Syndrome: Should Be Considered When Diagnosing DRESS Syndrome

• Kang YJ
• Lee J
• Ahn J
• Park S
• Shin MY
• Lee HW

• KMID: 2407682
• DOI: http://doi.org/10.3346/jkms.2018.33.e106

Abstract

Trichloroethylene (TCE) is an organic solvent that is used for degreasing and removing impurities from metal parts. However, this solvent's characteristics and hypersensitivity can produce clinical patterns and laboratory data that mimic drug rash with eosinophilia and systemic symptoms (DRESS) syndrome. Thus, exposure confirmation is critical to making an accurate diagnosis. This is a case of TCE-induced hypersensitivity syndrome (TCE HS) in a 24-year-old Indonesian man who was working in an electro-plating business. He was admitted to a referral hospital after one month of working, and exhibited a fever with skin symptoms. He was administered immunosuppressive therapy based on an assumed diagnosis of DRESS syndrome, although he subsequently experienced cardiac arrest and did not respond to resuscitation. An investigation into his disease history confirmed that he was prescribed medications one week before he developed the skin disease, and had been periodically exposed to TCE for the previous 4 weeks. Based on these findings, it was believed that his clinical course was caused by TCE HS, rather than DRESS syndrome.

Keyword

Trichloroethylene; Hypersensitivity Syndrome; DRESS Syndrome; Stevens-Johnson Syndrome; Toxic Epidermal Necrolysis

MeSH Terms

Commerce
Diagnosis
Drug Hypersensitivity Syndrome*
Eosinophilia
Exanthema
Fever
Heart Arrest
Humans
Hypersensitivity*
Referral and Consultation
Resuscitation
Skin
Skin Diseases
Stevens-Johnson Syndrome
Trichloroethylene*
Young Adult
Trichloroethylene