Trichloroethylene-Associated Hypersensitivity: Clinical Patterns Supporting an Idiosyncratic Solvent-Induced Liver Injury Framework.

Occupational exposure to trichloroethylene (TCE) has been associated with rare but severe systemic hypersensitivity reactions frequently accompanied by hepatic dysfunction, yet these reactions are often discussed within exposure-centered toxicological paradigms. This review synthesizes clinical and epidemiologic evidence on occupational trichloroethylene-associated hypersensitivity to clarify its characteristic phenotype and interpret the condition within a framework of idiosyncratic solvent-induced liver injury (ISILI). Across published reports, a highly consistent phenotype was observed, characterized by a latency period of approximately 2-8 weeks, low and variable attack rates (<1% to 12.5%), absence of a clear exposure-response relationship, frequent hepatic involvement, and rapid clinical relapse following re-exposure. These recurrent features differ from classical dose-dependent solvent toxicity and delineate a susceptibility-driven pattern consistent with established models of idiosyncratic liver injury. These findings support interpreting trichloroethylene-associated hypersensitivity within an idiosyncratic solvent-induced liver injury (ISILI) framework and highlight the limitations of conventional exposure-based prevention strategies.