F. Caprioli et al., "Hepatitic flare", asthenia, peripheral polyneuropathy and diffuse liver steatosis in a hepatitis C virus asymptomatic chronic carrier, DIG LIVER D, 33(4), 2001, pp. 359-362
In July 2000, a 62-year-old female, with a ten-year history of chronic hepa
titis C virus infection and persistently normal aspartate aminotransferase
and alanine aminotransferase levels, presented with asthenia, weight loss,
peripheral polyneuropathy and increased levels of aspartate aminotransferas
e (8 times upper normal limit), alanine aminotransferase (10 times upper no
rmal limit) and gamma glutamyltransferase (6 times upper normal limit). The
ultrasound findings were consistent with massive liver steatosis. The pati
ent had been previously diagnosed elsewhere as having hepatitis C virus-rel
ated "hepatitic flare" with neurological involvement related to concomitant
mixed type-ill cryoglobulinaemia. However: intense exposure to trichloroet
hylene since April 2000 was revealed and liver histology was fully consiste
nt with non-alcoholic steatohepatitis. The pathogenetic role of the solvent
was definitely supported by the complete clinical and biochemical remissio
n within six months of trichloroethylene withdrawal.