Isoniazid
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Isoniazid Liver toxicity: 3 case reports
A retrospective study of 1150 patients, who underwent kidney transplant between January 2014 and December 2017, described one woman and two men, aged 45–63 years, who developed liver toxicity during preventive treatment with isoniazid for tuberculosis (TB) [routes, dosages, durations of treatments to reactions onsets and outcomes not stated]. Patient 108: The 45-year-old man, who had undergone liver transplant 8 months previously, underwent living donor kidney transplant. After the kidney transplant, he started receiving interferon-γ releasing assay response (IGRA)-based isoniazid treatment to prevent TB. After 28 days of treatment, isoniazid was discontinued due to liver toxicity with AST of 161 IU/L, ALT of 168 IU/L, ALP of 511 IU/L and total bilirubin of 0.5 mg/dL. Three years later, he died due to recurrence of hepatocellular carcinoma. Patient 172: The 56-year-old woman underwent living donor kidney transplant. After the kidney transplant, she started receiving interferon-γ releasing assay response (IGRA)-based isoniazid treatment to prevent TB. After 10 days of treatment, isoniazid was discontinued due to isoniazid-related liver toxicity with AST of 72 IU/L, ALT of 391 IU/L, ALP of 34 IU/L and total bilirubin of 0.4 mg/dL. One week later, isoniazid was restarted, and she completed 9 months of isoniazid treatment. Patient 228: The 63-year-old man underwent living donor kidney transplant. After the kidney transplant, he started receiving interferon-γ releasing assay response (IGRA)-based isoniazid treatment to prevent TB. After 4 days of treatment, isoniazid was discontinued due to liver toxicity with AST of 81 IU/L, ALT of 208 IU/L, ALP of 53 IU/L and total bilirubin of 1.4 mg/dL. Isoniazid was not restarted. Kim S-H, et al. The usefulness of quantitative interferon-gamma releasing assay response for predicting active tuberculosis in kidney transplant recipients: A quasiexperimental study. Journal of Infection 81: 403-410, No. 3, Sep 2020. Available from: URL: http://doi.org/10.1016/j.jinf.2020.06.070
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Reactions 26 Sep 2020 No. 1823
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