Dimethylacetamide-induced toxic hepatitis in spandex workers: clinical presentation and treatment outcomes

Author:

Wang J1ORCID,Chen G23

Affiliation:

1. Department of Gastroenterology, Zhejiang Rongjun Hospital, Jiaxing 314000

2. Department of Biopharmaceutical Sciences, College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou 310018

3. Zhejiang Provincial Key Laboratory of Silkworm Bioreactor and Biomedicine, Hangzhou 310018, China

Abstract

Abstract Background Dimethylacetamide (DMAc) exposure has been associated with toxic hepatitis, and no clinical treatment has been reported. Aim To investigate the clinical manifestations of DMAc-induced symptoms and how to rescue the functional loss due to occupational exposure. Design Clinical observations of 60 spandex factory workers with the exposure to DMAc from January, 2017–19. Methods Chinese drugs (reduced glutathione, polyene phosphatidylcholine, glycyrrhizin compound, Hugan tablets and ornithine aspartate) were used to evaluate the therapeutic improvements in DMAc-exposed patients. Results Our data found that 58.3% patients had no distinct clinical symptoms, but 41.7% patients felt fatigue, and 21.7% patients suffered abdominal discomfort and appetite loss, and 8.3% patients had yellow skin and sclera. The ultrasonic and CT imaging revealed that some patients have fatty livers, intrahepatic calcifications, hepatomegaly, gallbladder wall edema and abdominal effusions. Biochemical analysis showed that the alanine aminotransferase (ALT) (P < 0.001), aspartate aminotransferase (AST) (P < 0.001), lactate dehydrogenase (LDH) (P < 0.001) and bilirubin (P < 0.01) statistically decreased after the drug treatment, but alkaline phosphatase (P >0.05) and glutamyl transpeptidase (P> 0.05) did not decrease. Twenty-nine out of the thirty-one patients’ abnormal blood ammonia recovered. The risk factor of ALT on hospitalization time was significantly related (P < 0.01). Conclusions The drugs above are sufficient to rescue functional loss in DMAc-induced toxic hepatitis, in part via the regulations of ALT, AST, LDH, bilirubin and ammonia. Workers with the exposure to DMAc should receive specific drugs to maintain the health and prevent functional loss in the long term.

Funder

Sci-Tech Planning Project of Zhejiang Province

Department of Sci-Tech of Zhejiang Province

Publisher

Oxford University Press (OUP)

Subject

General Medicine

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