Lung injury due to trichloroethylene aspiration

Trichloroethylene (TCE), as other halogenated hydrocarbons, is a liquid, highly volatile, lipophilic compound. Widely used as industrial solvent and domestic dry cleaning agent, it is very well absorbed from both gastrointestinal and respiratory tract, besides intact skin. It is also known as a substance of abuse due to its anaesthetic and dysforic effects. TCE is metabolized in the liver by CYP2E1 isoenzyme of cytochrome P450 oxidative system, thus producing an intermediate reactive metabolite (epoxide free radical). It is excreted unchanged by the lungs and as inactive metabolite (trichloroacetic acid) in the urine. Whatever the absorption route, TCE toxicity on CNS (coma due to reversible interaction with neuronal membrane), liver (epoxide-induced acute hepatitis) and cardiovascular system (arrhythmias due to sensitization of beta 1-catecholamine receptors) is very well known. Lung injuries following TCE aspiration are less reported. A recent case is here reported.