Case Report: Evaluating toxic encephalopathy from occupational 1,2-dichloroethane exposure: magnetic resonance imaging contributions

Background1,2-Dichloroethane is a commonly used industrial solvent. Acute or subacute occupational exposure can cause toxic encephalopathy; however, long-term changes in brain imaging are not frequently documented.Case presentationA 39-year-old woman developed dizziness and forgetfulness 9 days afte...

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Main Authors: Jieru Wang, Tianzi Jian, Guangcai Yu, Baotian Kan, Wei Li, Xiangdong Jian
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Toxicology
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Online Access:https://www.frontiersin.org/articles/10.3389/ftox.2025.1557995/full
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author Jieru Wang
Jieru Wang
Tianzi Jian
Guangcai Yu
Guangcai Yu
Baotian Kan
Baotian Kan
Wei Li
Xiangdong Jian
author_facet Jieru Wang
Jieru Wang
Tianzi Jian
Guangcai Yu
Guangcai Yu
Baotian Kan
Baotian Kan
Wei Li
Xiangdong Jian
author_sort Jieru Wang
collection DOAJ
description Background1,2-Dichloroethane is a commonly used industrial solvent. Acute or subacute occupational exposure can cause toxic encephalopathy; however, long-term changes in brain imaging are not frequently documented.Case presentationA 39-year-old woman developed dizziness and forgetfulness 9 days after performing glue coating. Her symptoms improved significantly after a 7-day break from work. However, after resuming work for 3 days, she returned with dizziness, headache, and anxiety. Brain magnetic resonance imaging (MRI) showed extensive edema and diffuse abnormal signal intensities in the cerebellar dentate nucleus, basal ganglia, and bilateral cerebral white matter. She was treated with salvianolate injection, magnesium isoglycyrrhizinate, and neurotrophic therapy. Two weeks after admission, her symptoms improved significantly, except for mild uncoordinated walking. The range of abnormal MRI signals remained consistent with previous findings. She was discharged the following day. She experienced worsened headache 3 days later. Computed tomography revealed diffuse cerebral edema. Despite treatment with mannitol, her headache rapidly worsened and was accompanied by nausea, vomiting, hypertension, bradycardia, and dyspnea, ultimately leading to unconsciousness. Follow-up MRI showed findings similar to the previous scan, except that the apparent diffusion coefficient (ADC) sequence had changed from hypointense to hyperintense. Shortly after the MRI examination, she experienced respiratory arrest. Unfortunately, she died 32 days after her initial admission due to severe cerebral injury and infection.ConclusionOccupational exposure to 1,2-dichloroethane can lead to toxic encephalopathy, presenting as diffuse progressive cerebral edema. This case shows that brain imaging findings may not always correlate with the patient’s clinical condition, so careful monitoring is essential.
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spelling doaj-art-4cf0899df1b24c7fb815de092e5ddd7d2025-08-20T02:20:41ZengFrontiers Media S.A.Frontiers in Toxicology2673-30802025-06-01710.3389/ftox.2025.15579951557995Case Report: Evaluating toxic encephalopathy from occupational 1,2-dichloroethane exposure: magnetic resonance imaging contributionsJieru Wang0Jieru Wang1Tianzi Jian2Guangcai Yu3Guangcai Yu4Baotian Kan5Baotian Kan6Wei Li7Xiangdong Jian8Department of Critical Care Medicine, The 5th People’s Hospital of Jinan, Jinan, Shandong, ChinaDepartment of Poisoning and Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaDepartment of Poisoning and Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaDepartment of Poisoning and Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaDepartment of Nephrology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaDepartment of Poisoning and Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaDepartment of Geriatric Medicine, Department of Nursing, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaDepartment of Nephrology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaDepartment of Poisoning and Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaBackground1,2-Dichloroethane is a commonly used industrial solvent. Acute or subacute occupational exposure can cause toxic encephalopathy; however, long-term changes in brain imaging are not frequently documented.Case presentationA 39-year-old woman developed dizziness and forgetfulness 9 days after performing glue coating. Her symptoms improved significantly after a 7-day break from work. However, after resuming work for 3 days, she returned with dizziness, headache, and anxiety. Brain magnetic resonance imaging (MRI) showed extensive edema and diffuse abnormal signal intensities in the cerebellar dentate nucleus, basal ganglia, and bilateral cerebral white matter. She was treated with salvianolate injection, magnesium isoglycyrrhizinate, and neurotrophic therapy. Two weeks after admission, her symptoms improved significantly, except for mild uncoordinated walking. The range of abnormal MRI signals remained consistent with previous findings. She was discharged the following day. She experienced worsened headache 3 days later. Computed tomography revealed diffuse cerebral edema. Despite treatment with mannitol, her headache rapidly worsened and was accompanied by nausea, vomiting, hypertension, bradycardia, and dyspnea, ultimately leading to unconsciousness. Follow-up MRI showed findings similar to the previous scan, except that the apparent diffusion coefficient (ADC) sequence had changed from hypointense to hyperintense. Shortly after the MRI examination, she experienced respiratory arrest. Unfortunately, she died 32 days after her initial admission due to severe cerebral injury and infection.ConclusionOccupational exposure to 1,2-dichloroethane can lead to toxic encephalopathy, presenting as diffuse progressive cerebral edema. This case shows that brain imaging findings may not always correlate with the patient’s clinical condition, so careful monitoring is essential.https://www.frontiersin.org/articles/10.3389/ftox.2025.1557995/full1,2-dichloroethanetoxic encephalopathyoccupational exposurecerebral edemamagnetic resonance imagingclinical features
spellingShingle Jieru Wang
Jieru Wang
Tianzi Jian
Guangcai Yu
Guangcai Yu
Baotian Kan
Baotian Kan
Wei Li
Xiangdong Jian
Case Report: Evaluating toxic encephalopathy from occupational 1,2-dichloroethane exposure: magnetic resonance imaging contributions
Frontiers in Toxicology
1,2-dichloroethane
toxic encephalopathy
occupational exposure
cerebral edema
magnetic resonance imaging
clinical features
title Case Report: Evaluating toxic encephalopathy from occupational 1,2-dichloroethane exposure: magnetic resonance imaging contributions
title_full Case Report: Evaluating toxic encephalopathy from occupational 1,2-dichloroethane exposure: magnetic resonance imaging contributions
title_fullStr Case Report: Evaluating toxic encephalopathy from occupational 1,2-dichloroethane exposure: magnetic resonance imaging contributions
title_full_unstemmed Case Report: Evaluating toxic encephalopathy from occupational 1,2-dichloroethane exposure: magnetic resonance imaging contributions
title_short Case Report: Evaluating toxic encephalopathy from occupational 1,2-dichloroethane exposure: magnetic resonance imaging contributions
title_sort case report evaluating toxic encephalopathy from occupational 1 2 dichloroethane exposure magnetic resonance imaging contributions
topic 1,2-dichloroethane
toxic encephalopathy
occupational exposure
cerebral edema
magnetic resonance imaging
clinical features
url https://www.frontiersin.org/articles/10.3389/ftox.2025.1557995/full
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