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.
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

Anemia is the most common hematologic finding in patients with advanced infections caused by human immunodeficiency virus (HIV) or advanced acquired immunodeficiency syndrome (AIDS). Among many etiologies of HIV-associated anemia, vitamin B12 deficiency plays an important role, mostly due to malabsorption or HIV enteropathy. We experienced a case of megaloblastic anemia caused by vitamin B12 deficiency in a male patient with an AIDS who had no structural gastrointestinal problem. He showed severe anemia, leukopenia, thrombocytopenia and suspicious neurologic manifestations such as aggravation of dementia and gait disturbance. With vitamin B12 and folate treatment, the patient's general condition and hematologic features were improved successfully.
Acquired Immunodeficiency Syndrome ; Anemia ; Anemia, Megaloblastic ; Dementia ; Folic Acid ; Gait ; HIV ; HIV Enteropathy ; Humans ; Leukopenia ; Male ; Neurologic Manifestations ; Thrombocytopenia ; Vitamin B 12 ; Vitamin B 12 Deficiency ; Vitamins