Dimethylacetamide-induced toxic hepatitis in spandex workers: Clinical presentation & treatment outcomes

BACKGROUND: Dimethylacetamide (DMAc) has been reported to induce toxic hepatitis both in patients and animal models. AIM: To research the clinical manifestations of this disease and how to rescue the DMAc induced functional loss in patients. DESIGN: In this study, 60 spandex factory workers were found with DMAc exposure. METHODS: Chinese drugs (reduced glutathione, polyene phosphatidylcholine, glycyrrhizin compound, Hugan tablets and ornithine aspartate) were used to rescue further functional loss in patients. RESULTS: We 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 aminotransferase (ALT) (P 0.05) and glutamyl transpeptidase (γ-GT) (P > 0.05) did not decrease. 29/31 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.