Hepatic Disease in the Spanish Toxic Oil Syndrome. A Thirty Months Follow-up Study

Clinical and biological evidence of liver disease was found in 99 out of 242 (40%) patients hospitalized with acute manifestations of the Spanish toxic oil syndrome. No patient was alcoholic. According to the severity of liver involvement, patients were classified in 3 groups and followed up for at least 30 months. Group I included 65 patients with a transient increase of serum aminotransferase activity as the only evidence of liver disease. This abnormality disappeared within 2 months in all these patients. Group II included 18 patients with raised aminotransferases and alkaline phosphatase. At the end of follow-up, liver tests remained slightly abnormal in 4 patients of this group (22%) and a liver biopsy revealed minor changes in 3 of them. Group III included 16 patients with raised aminotransferases, alkaline phosphatase and bilirubin. Thirty months after the acute episode, liver function tests remained abnormal in 8 patients (50%); a liver biopsy, performed in 5 cases, showed changes suggesting chronic biliary disease in 2, and fibrosteatosis, chronic hepatitis and minimal changes in each of the remaining 3. Pulmonary, cutaneous, vascular, neuromuscular and other extra-hepatic disturbances were noted in a large number of patients but no relationship was observed between the degree of hepatic disfunction and the presence and severity of systemic manifestations of the toxic oil syndrome.