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Isoniazid induced liver injury associated with jaundice


Authors: M. Sučík 1;  R. Rosoľanka 1;  L. Nosáková 2;  D. Krkoška 1;  K. Šimeková 1
Authors‘ workplace: Klinika infektológie a cestovnej medicíny JLF UK a UN Martin 2 Interná klinika – gastroenterologická JLF UK a UN Martin 1
Published in: Gastroent Hepatol 2024; 78(2): 156-164
Category: Hepatology
doi: https://doi.org/10.48095/ccgh2024156

Overview

Isoniazid belongs to the first line antituberculosis drugs and can be used for the treatment of both active and latent tuberculosis infections. It is a part of combined regimens, for the preventive treatment of tuberculosis isoniazid can be used in monotherapy as well. Even though elevations in serum aminotransferases levels during isoniazid therapy are seen frequently, the development of symptomatic hepatitis is rare, according to specialised literature. This article describes a case of a patient who developed drug-induced liver injury accompanied by jaundice during the isoniazid preventive treatment of tuberculosis. It also provides a summary of the currently known risk factors, pathogenesis, and incidence of hepatotoxicity observed throughout therapy with this antituberculosis drug. We also illustrate the process of diagnosing drug--induced liver injury in clinical practice settings with the utilisation of the updated RUCAM score.

Keywords:

jaundice – isoniazid – drug-induced liver injury – tuberculosis preventative therapy – updated RUCAM score.


Sources

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Zoznam použitých skratiek

ALF – acute liver failure, akútne zlyhanie pečene
ALP – alkalická fosfatáza
ALT – alanínaminotransferáza
anti-gp210 – protilátky proti glykoproteínu 210
anti-LC1 – anti-liver cytosol antibodies type 1, protilátky proti pečeňovému cytosolovému antigénu typu 1
anti-LKM1 – anti-liver-kidney microsome antibodies type 1, protilátky proti mikrozómom pečene a obličiek typu 1
anti-M2 – anti-mitochondrial M2 antibodies, protilátky proti mitochondriám typu M2
anti-PML – anti-promyelocytic leukemia protein antibodies, protilátky proti proteínu promyelocytárnej leukémie
anti-SLA – anti-soluble liver antigen antibodies, protilátky proti solubilnému pečeňovému antigénu
AST – aspartátaminotransferáza
ATS – The American Thoracic Society, Americká hrudná spoločnosť
BK – Kochov bacil, Mycobacterium tuberculosis
cART – combination antiretroviral treatment, kombinovaná antiretrovírusová terapia
CDC – The Centers for Disease Control and Prevention, Strediská pre kontrolu a prevenciu chorôb
CMV – cytomegalovírus
dif. dg. – diferenciálna diagnóza
DILI – drug-induced liver injury, liekmi navodené poškodenie pečene
EBV – vírus Epsteina-Barrovej
GGT – g-glutamyltransferáza
HAV – vírus hepatitídy A
HBV – vírus hepatitídy B
HCV – vírus hepatitídy C
HEV – vírus hepatitídy E
HSV – herpes simplex vírus
IDSA – Infectious Diseases Society of America, Spoločnosť infekčného lekárstva v USA
INH – isonicotinic acid hydrazide, hydrazid kyseliny izonikotínovej, izoniazid
INR – international normalised ratio, medzinárodný normalizovaný pomer
KIaCM UNM – Klinika infektológie a cestovnej medicíny Univerzitnej nemocnice Martin
MRCP – magnetická rezonančná cholangiopankreatikografia
PCR – polymerase chain reaction, polymerázová reťazová reakcia
SPC – summary of product characteristics, súhrn charakteristických vlastností lieku
RUCAM – Roussel Uclaf Causality Assessment Method
TBC – tuberkulóza
TPT – tuberculosis preventative therapy, preventívna liečba TBC
ULN – upper limit of the normal range, horná hranica fyziologických referenčných hodnôt
USG – ultrasonografia
VZV – varicella zoster vírus

ORCID autorov

M. Sučík 0009-0005-0300-6330,

R. Rosoľanka 0000-0003-0429-6833,

L. Nosáková 0000-0003-0432-8575.

Doručené/Submitted: 7. 1. 2024
Prijaté/Accepted: 26. 2. 2024
MUDr. Martin Sučík
Klinika infektológie a cestovnej medicíny
JLF UK a UN Martin
Kollárova 2
036 01 Martin
martinsucik@gmail.com
Labels
Paediatric gastroenterology Gastroenterology and hepatology Surgery
Topics Journals
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