Progressive systemic sclerosis associated with exposure to trichloroethylene.

Trichloroethylene (CHCL = CCL2) is a colorless aliphatic organic solvent with both historical use in medicine as an anesthetic agent and current use in industry as a degreasing agent. Although neither the etiology nor pathogenesis of progressive systemic sclerosis (scleroderma) has been established, this disease has been associated with a wide variety of seemingly unrelated compounds, including exposure to organic solvents. The authors describe a 47-year-old woman with previous excellent health who developed fatal progressive systemic sclerosis after a single 2.5-hour predominantly dermal exposure to trichloroethylene. During a period of 10 months the patient developed proximal scleroderma, reflux esophagitis, microangiopathic hemolytic anemia, restrictive pulmonary disease, pericarditis with effusion, and renal insufficiency with severe hypertension. Renal and skin biopsies were consistent with progressive systemic sclerosis.