Hepatotoxicity Induced by Anti-Tubercular Drugs Therapy: A Case Report
Anti-tubercular therapy induced liver injury (ATTILI) is the most important risk for the past many years. Many pre-existing factors and conditions like persisting liver injury, female gender, alcohol abuse etc. are important risk factors for the ATT induce liver injury. I read many case reports and literature review for the drugs induce liver injury, and concluded the results, ATT drugs are the most responsible for the liver injury during the therapy periods. The present case was 42-year-old male patient and known case of pulmonary tuberculosis, patients were on the ATT drugs therapy in the last 14 days. After few days of therapy, he produced signs of vomiting (multiple episode), fever (high grade), abdomen pain, coughing, loss of appetite, epigastric discomforts & generalized weakness. On general examination the patient was found to produce signs of Jaundice with yellowish appearance of the sclera. Pulmonologist had firstly withdrawal the anti-tubercular drugs therapy and started the modified anti-tubercular drugs therapy. As a Clinical pharmacist we advise the patients & patients relatives, proper monitoring of liver and renal function test should also be carried out by the health care professional specialist from time to time in order to avoid critical situations.
Keywords: Anti-tubercular therapy, Anti-tubercular therapy induced liver injury, Pulmonologist, Hepatotoxicity.
2. Bangwal R, Rawat J, Joshi Y. Hepatitis Induced by Anti-Tubercular Therapy and Chronic Alcoholism: A Case Report. Journal of Drug Delivery and Therapeutics, 2019; 9(4):598-600p.
3. Bangwal R, Saklani S, Bisht S, Rawat J, Jangpani DS. Case Report on Anti-Tubercular Drugs Induced Gastritis. World Journal of Pharmaceutical Research, 2020; Volume 9 (4):732-736p.
4. Page KR, Sifakis F, Montes de OR, Cronin WA, Doherty MC, Federline L. Improved Adherence and Less Toxicity with Rifampicin vs Isoniazid for Treatment of Latent Tuberculosis, Arch Internal Medicine 2006; (166):1863-1870p.
5. Hussain Z, Kar P, Hussain SA. Antituberculosis drug-induced hepatitis: risk factors, prevention and management, Indian Journal of Experimental Biology 2003; 41:1226-1232p.
6. Tostmann A, Boeree MJ, Aarnoutse RE, De Lange WCM, Van der Ven AJ, and Dekhuijzen R. Antituberculosis drug-induced hepatotoxicity: Concise up-to-date review, Journal of Gastroenterol Hepatology 2008; 23:192-202p.
7. Khalili H, Dashti KS, Rasoolinejad M, Rezaie L, Etminani M, Anti-tuberculosis drugs related hepatotoxicity; incidence, risk factors, pattern of changes in liver enzymes and outcome, DARU 2010; 17:32009-32012p.
8. Devarbhavi H. An update on drug-induced liver injury, Journal of Clinical Experiment Hepatology 2012; 2(3):247-259p.
9. Singla R, Sharma SK, Mohan A, Makharia G, Sreenivas V, Jha B, Kumar S, Sarda P, Singh S. Evaluation of risk factors for antituberculosis treatment induced hepatotoxicity. Ind J Med Respiratory 2010; 132:81-86p.
10. Yee D, Valiquette C, Pelletier M, Parisien I, Rocher I, Menzies D. Incidence of serious side effects from first line antituberculosis drugs among patients treated for active tuberculosis. Am J Respiratory & Critical Care Med 2003; 167:1472-1477p.
11. Kishore PV, Palaian S, Paudel R, Mishra P, Prabhu M, Shankar PR. Drug induced hepatitis with anti-tubercular chemotherapy: Challenges and difficulties in treatment. Kathmandu University Med J 2007; 5(2):256-260p.
12. Girling DJ. The hepatic toxicity of antituberculosis regimens containing isoniazid, rifampicin and pyrazinamide. Tubercle 1978; 59(1):13-32p.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).