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Case Report of Isoniazid-Related Acute Liver Failure Requiring Liver Transplantation

The prevalence of latent tuberculosis infection (LTBI) in the United States in 2011 and 2012 was estimated at 4.4–4.8%. As of 2015, 12.4 million people still possessed LTBI. Isoniazid, or isonicotinic acid hydrazine (INH), is the most commonly used medication among varying regimens that exist in the...

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Autores principales: Li, Andrew A., Dibba, Pratima, Cholankeril, George, Kim, Donghee, Ahmed, Aijaz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6023516/
https://www.ncbi.nlm.nih.gov/pubmed/29783726
http://dx.doi.org/10.3390/diseases6020040
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author Li, Andrew A.
Dibba, Pratima
Cholankeril, George
Kim, Donghee
Ahmed, Aijaz
author_facet Li, Andrew A.
Dibba, Pratima
Cholankeril, George
Kim, Donghee
Ahmed, Aijaz
author_sort Li, Andrew A.
collection PubMed
description The prevalence of latent tuberculosis infection (LTBI) in the United States in 2011 and 2012 was estimated at 4.4–4.8%. As of 2015, 12.4 million people still possessed LTBI. Isoniazid, or isonicotinic acid hydrazine (INH), is the most commonly used medication among varying regimens that exist in the treatment of tuberculosis and LTBI. INH-related hepatotoxicity is a well-known adverse effect of its use, often causing asymptomatic elevations in serum aminotransferase levels. These elevations are typically transient and reversible, but can cause acute, clinically-significant liver injury in rare cases. We report a case of a 67-year old male who developed subacute hepatic injury secondary to INH treatment for LTBI, and ultimately underwent liver transplantation due to the progression to hepatic decompensation, despite withdrawal of the medication. Because symptoms of INH hepatotoxicity are nonspecific and prognosis can be variable, clinicians must maintain a high index of suspicion for this adverse effect. As exemplified by this case, early recognition may be life-saving.
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spelling pubmed-60235162018-07-03 Case Report of Isoniazid-Related Acute Liver Failure Requiring Liver Transplantation Li, Andrew A. Dibba, Pratima Cholankeril, George Kim, Donghee Ahmed, Aijaz Diseases Case Report The prevalence of latent tuberculosis infection (LTBI) in the United States in 2011 and 2012 was estimated at 4.4–4.8%. As of 2015, 12.4 million people still possessed LTBI. Isoniazid, or isonicotinic acid hydrazine (INH), is the most commonly used medication among varying regimens that exist in the treatment of tuberculosis and LTBI. INH-related hepatotoxicity is a well-known adverse effect of its use, often causing asymptomatic elevations in serum aminotransferase levels. These elevations are typically transient and reversible, but can cause acute, clinically-significant liver injury in rare cases. We report a case of a 67-year old male who developed subacute hepatic injury secondary to INH treatment for LTBI, and ultimately underwent liver transplantation due to the progression to hepatic decompensation, despite withdrawal of the medication. Because symptoms of INH hepatotoxicity are nonspecific and prognosis can be variable, clinicians must maintain a high index of suspicion for this adverse effect. As exemplified by this case, early recognition may be life-saving. MDPI 2018-05-19 /pmc/articles/PMC6023516/ /pubmed/29783726 http://dx.doi.org/10.3390/diseases6020040 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Li, Andrew A.
Dibba, Pratima
Cholankeril, George
Kim, Donghee
Ahmed, Aijaz
Case Report of Isoniazid-Related Acute Liver Failure Requiring Liver Transplantation
title Case Report of Isoniazid-Related Acute Liver Failure Requiring Liver Transplantation
title_full Case Report of Isoniazid-Related Acute Liver Failure Requiring Liver Transplantation
title_fullStr Case Report of Isoniazid-Related Acute Liver Failure Requiring Liver Transplantation
title_full_unstemmed Case Report of Isoniazid-Related Acute Liver Failure Requiring Liver Transplantation
title_short Case Report of Isoniazid-Related Acute Liver Failure Requiring Liver Transplantation
title_sort case report of isoniazid-related acute liver failure requiring liver transplantation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6023516/
https://www.ncbi.nlm.nih.gov/pubmed/29783726
http://dx.doi.org/10.3390/diseases6020040
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