Forensic-medical evaluation of toxic hepatitis associated with surrogate alcohol poisoning

Medical cards of 1,116 inpatient victims of surrogate alcohol poisoning and 242 cases of its fatal outcome associated with jaundice were available for analysis form Irkutsk Region and other regions of the Russian Federation in the second half of 2006 and early 2007. The study revealed differences in hepatic lesions depending on the chemical nature of toxicants. Mixtures containing guanidine derivatives caused highly specific irreversible disturbance of bile transport in hepatocytes and biliary capillaries in the absence of cholestasis at the level of biliary ducts. Changes in hepatocytes of different type and genesis appear to be due to other toxic components and may be of use for the establishment of causal relation between hepatic lesions and concrete toxic mixtures.