Isoniazid
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Isoniazid-induced acute hepatitis: 2 case reports In a case series, two women aged 65 years and 62 years were described, who developed isoniazid-induced acute hepatitis following treatment with isoniazid for latent Mycobacterium tuberculosis infection. The 65-year-old woman was diagnosed with latent Mycobacterium tuberculosis infection. Her medical history was significant for diabetes and rheumatoid arthritis. She started receiving oral isoniazid 300mg daily. Her liver enzyme levels were not monitored. In January 2019, she was hospitalised with right sided flank pain and jaundice, which she had started experiencing eight weeks after the administration of first isoniazid dose. Laboratory investigation revealed severe cholestasis and cytolysis. She was diagnosed with isoniazid-induced acute hepatitis, with hepatocellular pattern (R=8.1). Naranjo scale attributed probable association between isoniazid and hepatitis. She was treated with acetylcysteine and unspecified liver function supportive therapy. Thereafter, her transaminases level decreased significantly. However, her cholestasis persisted. Two weeks after the admission, she was transferred to the ICU. She was treated with plasma exchange sessions. She developed acute liver failure and died four weeks after the admission. The 62-year-old woman was diagnosed with latent Mycobacterium tuberculosis infection. Her medical history was significant for psoriatic skin lesions. She started receiving oral isoniazid 300mg daily. Laboratory investigation revealed elevation of liver function tests six weeks after first isoniazid dose. She was hospitalised in May 2016. Ultrasound examination revealed liver steatosis. She was diagnosed with isoniazid-induced acute hepatitis, with hepatocellular pattern (R=5.4). Isoniazid was discontinued. She was treated with acetylcysteine, arginine, ursodeoxycholic acid, vitamin E and silimarin. Over a period of 40 weeks, her liver function tests slowly normalised. Complete resolution of hepatitis was noted. Radu C, et al. A case series of isoniazid induced liver injury. Journal of Gastrointestinal and Liver Diseases 28 (Suppl. 2): 69 (plus poster) abstr. PP 61, Jun 2019. Available 803497643 from: URL: https://www.jgld.ro/jgld/index.php/jgld/supplements [abstract]
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Reactions 22 Aug 2020 No. 1818
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