Centrilobular Hepatic Necrosis and Acute Renal Failure in "Solvent Sniffers"

Three teenagers with a history of drug abuse developed acute hepatic injury after the inhalation of Carbona® cleaning fluid, a commercial preparation that contains trichloroethylene. Two of these patients had evidence of acute renal injury, presumably due to tubular necrosis. Electrocardiographic and electroencephalographic abnormalities were also noted. Hepatic biopsies in two patients showed acute centrilobular necrosis. Both biopsies also showed evidence of mild centrilobular fibrosis, probably a result of previous injury from exposure to trichloroethylene. Carbona "sniffing" seems to be increasingly popular among adolescents, and its use in a group that has abused other drugs complicates an already difficult situation.