Autoantibodies to hepatic microsomal carboxylesterase in halothane hepatitis

Halothane hepatitis can be life-threatening and this severe adverse reaction may arise via an immune process. We have detected autoantibodies to purified human liver microsomal carboxylesterase in sera of 17 out of 20 patients with halothane hepatitis (85%) but not in 9 halothane-exposed controls and in only 2 (at low levels) of 33 patients with liver disease due to other causes. Immunohistochemical studies localised the carboxylesterase predominantly to the cnetrilobular region of liver sections, which is consistent with the area affected by halothane hepatitis. Human hepatic micromosal carboxylesterase is a target antgen in halothane hepatitis, and an immune response to this protein may be involved in the liver damage observed. Lancet 1993; 342: 963–64