Isoflurane hepatotoxicity in a patient with a previous history of halothane-induced hepatitis

Halogenated volatile anesthetics have been associated with liver injury. Most reported cases have been linked to halothane and enflurane. Cross-sensitization between the latter agents has also been documented. Isoflurane hepatitis is extremely rare, and only a few convincing cases have been published. Moreover, clinical cases of cross-sensitization of isoflurane with other haloalkanes have not been reported. We describe a case of hepatic dysfunction 2 weeks after isoflurane anesthesia in a 35-year-old obese woman with a previous history of halothane hepatitis. The diagnosis was made on the basis of exposure to isoflurane, the delay between the time of exposure and the onset of jaundice, sind the exclusion of other causes of liver dysfunction. This case reiterates the recommendation that patients who sustain liver injury from one haloalkane should not be exposed to another.