BCG vaccine/isoniazid/rifampicin
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Axillary lymphadenitis and hepatotoxicity: case report A 9-month-old girl developed axillary lymphadenitis following administration of BCG vaccine, and she developed hepatotoxicity during treatment with isoniazid and rifampicin for axillary BCG lymphadenitis [routes and dosages not stated, not all times to reactions onsets clearly stated]. The girl received a standard set of vaccinations, including BCG vaccine, hepatitis B, oral polio and tetanus vaccines at birth. At the age of 1.5 months, she presented with massive splenomegaly accompanied by fever. Subsequent analyses led to the diagnosis of haemophagocytic lymphohistiocytosis (although she did not exhibit cytopenia). Therefore, she was treated with methylprednisolone, followed by ciclosporin and dexamethasone. She continued to do well on ciclosporin and dexamethasone until the age of 9 months, when she developed axillary lymphadenitis related to BCG vaccine administration. Therefore, the girl was treated with ethambutol, isoniazid and rifampicin. However, she subsequently developed drug-induced hepatotoxicity due to isoniazid and rifampicin; hence, after 2.5 months of therapy, her treatment regimen was changed to cotrimoxazole, ethambutol and levofloxacin. She was eventually found to harbour recessive loss-of-function mutations in the NCKAP1L gene, which was believed to have resulted in a novel syndrome combining immunodeficiency, hyperinflammation and lymphoproliferation [ADR outcomes not stated]. Castro CN, et al. NCKAP1L defects lead to a novel syndrome combining immunodeficiency, lymphoproliferation, and hyperinflammation. Journal of Experimental Medicine 803514654 217: No. 12, Aug 2020. Available from: URL: http://doi.org/10.1084/JEM.20192275
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Reactions 14 Nov 2020 No. 1830
