Specific antibodies to halothane-induced liver antigens in halothane-associated hepatitis

Antibodies to halothane-altered liver cell determinants (halothane antibodies) have previously been detected in serum of patients with fulminant hepatic failure after halothane anaesthesia. However, their diagnostic value has not been reported in patients with non-fulminant hepatitis. Sera from 39 patients who developed hepatitis following halothane anaesthesia between January 1983 and December 1985 were tested for antibodies to halothane-induced liver antigens using an ELISA; 22 of these patients had hepatitis without encephalopathy. Nineteen of the sera were from patients anaesthetized during 1985; four of the patients were aged 15 yr or less. All patients had undergone previous anaesthesia 17 days to 13 yr (median 3 yr) earlier. In 19 of the patients the final operation was a minor surgical procedure, lasting less than 45 min. In 13 patients a previous adverse reaction to halothane was documented in the case records. Twelve of the patients died. Halothane antibodies were detected in 12 of the 16 (75%) patients with hepatic encephalopathy and 16 of the 23 (70%) who did not develop encephalopathy, demonstrating that halothane antibodies are detectable in a wider spectrum of halothane-associated liver damage than previously appreciated.