Severe carbon tetrachloride poisoning with recovery followed by fatal homologous serum hepatitis.

Abstract A case of accidental severe carbon tetrachloride poisoning is described in which recovery appears to have been made possible by means of exchange blood transfusions at a critical stage of uremia. After complete recovery the patient died about four months later from a fulminant homologous serum hepatitis. Limited postmortem examination showed hemorrhagic necrosis of the pancreas and massive necrosis of the liver. A brief review is presented of the use of exchange transfusions and extrarenal excretion methods (peritoneal and intestinal lavage and the artificial kidney) in the management of lower nephron nephrosis. Homologous serum hepatitis may represent a serious complication of exchange blood transfusions. Data are presented which indicate that carbon tetrachloride poisoning in industry and among incidental and household users continues to be a significant clinical and public health problem. In five states two hundred seventeen cases of carbon tetrachloride poisoning were recorded for the three-year period 1949 to 1951 with a 10 per cent mortality. The authors are of the opinion that the public should be more fully informed of the potential serious toxic effects of carbon tetrachloride. Small as well as large quantities of this solvent should be labeled with the prominent display of the word POISONOUS in addition to the usual skull and crossbones insignia.