barcelona . spain - European Association for the Study of the Liver

BARCELONA . SPAIN
168 POSTGRADUATE COURSE SYLLABUS ALCOHOLIC LIVER DISEASE 169
APRIL 18 - 19/2012 THE INTERNATIONAL LIVER CONGRESS TM 2012
Table 1. Compounds potentially associated with toxicity in unrecorded alcohol
diethyl phthalate (DEP) (0.08–0.15%) and PHMG (0.10–0.14%). PHMG is an effective antiseptic and is
commonly used for suppression of hospital infection in the Russian Federation (16) and DEP denatures
alcohol (17). Several other studies detected PHMG together with DEP in disinfectants that were used as
an ethanol source in poisoning cases in Russia (6, 16, 18). On the basis of clinical manifestations and
laboratory findings of 579 poisoned patients, Ostapenko et al. (15) concluded that the cholestatic hepatitis
(histologically different from conventional alcoholic liver disease) was caused by PHMG, while a history of
alcohol-induced hepatitis and cirrhosis contributed to a more severe course of the poisoning. Other factors
such as DEP or chronic viral hepatitis may have further contributed to multifactorial liver damage. However,
little is known about the alcohol consumed, which led to these poisonings, the role of ethanol concentration,
drinking patterns, or the role of unrecorded consumption (10, 19).
CONCLUSIONS
Recent research has shown that concerns about the toxicity of unrecorded alcohol were mostly exaggerated
(4). For example, quantitative risk comparisons have shown that the potency of ethanol for liver toxicity is
at least 5,000 times greater than that of ethyl carbamate (20). Rather than by reference to alcohol quality,
liver cirrhosis rates could be better explained by the higher alcoholic strength of the unrecorded alcohol
consumed, problematic drinking patterns, lower socioeconomic status and poor health status and the
interaction effect between these factors (4).
Acknowledgements
The author is grateful for the assistance of Dr. Yulia Monakhova in conducting the statistical analysis.
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Other components besides ethanol analysed in unrecorded alcohols have not been found in the vast
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