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Digestive Diseases and Sciences

, Volume 59, Issue 7, pp 1370–1374 | Cite as

Isoniazid Hepatotoxicity Requiring Liver Transplantation

  • Edward Sheen
  • Robert J. Huang
  • Lindsay A. Uribe
  • Mindie H. Nguyen
Stanford Multidisciplinary Seminars

Case Presentation and Evolution

A 65-year-old female Peruvian immigrant was initially evaluated for potential initiation of anti-tumor necrosis factor (TNF)-α therapy for her poorly controlled rheumatoid arthritis. The patient had a history of thyroid cancer that had required thyroidectomy and replacement levothyroxine. The patient’s quantiferon test was positive, and she also had a history of aspartate transaminase (AST) and alanine transaminase (ALT) values between 40 and 60 IU/L for at least the previous 4 years. Previous laboratory evaluation had revealed a positive anti-nuclear antibody (ANA) titer at dilution of 1:640 with homogeneous pattern, positive anti-smooth muscle antibody, and elevated immunoglobulin G (IgG) levels at 2,310 mg/dL. The patient, however, denied any prior history of chronic liver disease; consequently, no further evaluation was pursued. Isoniazid (INH) prophylaxis for latent tuberculosis infection (LTBI), was instituted for an expected nine-month course. The...

Keywords

Hepatotoxicity American Thoracic Society Rifaximin Acute Viral Hepatitis Isoniazid Preventive Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Edward Sheen
    • 1
  • Robert J. Huang
    • 2
  • Lindsay A. Uribe
    • 2
  • Mindie H. Nguyen
    • 1
  1. 1.Division of Gastroenterology and Hepatology, Department of Medicine, School of MedicineStanford UniversityStanfordUSA
  2. 2.Department of MedicineStanford UniversityStanfordUSA

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