Acute and Fatal Isoniazid-Induced Hepatotoxicity: A Case Report and Review of the Literature
This paper describes a case of an acute and fatal isoniazid-induced hepatotoxicity and provides a review of the literature. A 65-year-old female diagnosed with latent Mycobacterium tuberculosis infection was receiving oral isoniazid 300 mg daily. She was admitted to the hospital for epigastric and r...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2016/3617408 |
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| author | Wissam K. Kabbara Aline T. Sarkis Paola G. Saroufim |
| author_facet | Wissam K. Kabbara Aline T. Sarkis Paola G. Saroufim |
| author_sort | Wissam K. Kabbara |
| collection | DOAJ |
| description | This paper describes a case of an acute and fatal isoniazid-induced hepatotoxicity and provides a review of the literature. A 65-year-old female diagnosed with latent Mycobacterium tuberculosis infection was receiving oral isoniazid 300 mg daily. She was admitted to the hospital for epigastric and right sided flank pain of one-week duration. Laboratory results and imaging confirmed hepatitis. After ruling out all other possible causes, she was diagnosed with isoniazid-induced acute hepatitis (probable association by the Naranjo scale). After discharge, the patient was readmitted and suffered from severe coagulopathy, metabolic acidosis, acute kidney injury, hepatic encephalopathy, and cardiorespiratory arrest necessitating two rounds of cardiopulmonary resuscitation. Despite maximal hemodynamic support, the patient did not survive. A review of the literature, from several European countries and the United States of America, revealed a low incidence of mortality due to isoniazid-induced hepatotoxicity when used as a single agent for latent Mycobacterium tuberculosis infection. As for the management, the first step consists of withdrawing isoniazid and rechallenge is usually discouraged. Few treatment modalities have been proposed; however there is no robust evidence to support any of them. Routine monitoring for hepatotoxicity in patients receiving isoniazid is warranted to prevent morbidity and mortality. |
| format | Article |
| id | doaj-art-4a1bf27179ef43c280d259f4bfab8754 |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-4a1bf27179ef43c280d259f4bfab87542025-02-03T01:33:15ZengWileyCase Reports in Infectious Diseases2090-66252090-66332016-01-01201610.1155/2016/36174083617408Acute and Fatal Isoniazid-Induced Hepatotoxicity: A Case Report and Review of the LiteratureWissam K. Kabbara0Aline T. Sarkis1Paola G. Saroufim2Department of Pharmacy Practice, School of Pharmacy, Lebanese American University (LAU), P.O. Box 36/F-37, Byblos, LebanonSchool of Pharmacy, Lebanese American University (LAU), Byblos, LebanonSchool of Pharmacy, Lebanese American University (LAU), Byblos, LebanonThis paper describes a case of an acute and fatal isoniazid-induced hepatotoxicity and provides a review of the literature. A 65-year-old female diagnosed with latent Mycobacterium tuberculosis infection was receiving oral isoniazid 300 mg daily. She was admitted to the hospital for epigastric and right sided flank pain of one-week duration. Laboratory results and imaging confirmed hepatitis. After ruling out all other possible causes, she was diagnosed with isoniazid-induced acute hepatitis (probable association by the Naranjo scale). After discharge, the patient was readmitted and suffered from severe coagulopathy, metabolic acidosis, acute kidney injury, hepatic encephalopathy, and cardiorespiratory arrest necessitating two rounds of cardiopulmonary resuscitation. Despite maximal hemodynamic support, the patient did not survive. A review of the literature, from several European countries and the United States of America, revealed a low incidence of mortality due to isoniazid-induced hepatotoxicity when used as a single agent for latent Mycobacterium tuberculosis infection. As for the management, the first step consists of withdrawing isoniazid and rechallenge is usually discouraged. Few treatment modalities have been proposed; however there is no robust evidence to support any of them. Routine monitoring for hepatotoxicity in patients receiving isoniazid is warranted to prevent morbidity and mortality.http://dx.doi.org/10.1155/2016/3617408 |
| spellingShingle | Wissam K. Kabbara Aline T. Sarkis Paola G. Saroufim Acute and Fatal Isoniazid-Induced Hepatotoxicity: A Case Report and Review of the Literature Case Reports in Infectious Diseases |
| title | Acute and Fatal Isoniazid-Induced Hepatotoxicity: A Case Report and Review of the Literature |
| title_full | Acute and Fatal Isoniazid-Induced Hepatotoxicity: A Case Report and Review of the Literature |
| title_fullStr | Acute and Fatal Isoniazid-Induced Hepatotoxicity: A Case Report and Review of the Literature |
| title_full_unstemmed | Acute and Fatal Isoniazid-Induced Hepatotoxicity: A Case Report and Review of the Literature |
| title_short | Acute and Fatal Isoniazid-Induced Hepatotoxicity: A Case Report and Review of the Literature |
| title_sort | acute and fatal isoniazid induced hepatotoxicity a case report and review of the literature |
| url | http://dx.doi.org/10.1155/2016/3617408 |
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