Abstract
A 10-year-old girl with cervical tuberculosis was treated with Isoniazid, Rimfampicin and Ethambutol. After 2 weeks of treatment a hepatotoxic reaction developed. Withdrawal of therapy resulted in complete clinical improvement and in normalization of all laboratory measurements. Treatment was restarted with Rifampicin, Pyrazinamid and Ethambutol. Liver enzyme levels were monitored weekly. Seven weeks after this three-drug regiment was started, all therapy was discontinued because of elevated liver enzyme levels. However, the patient died 2 weeks later of progressive fulminant hepatitis.
Abbreviations
- TBC:
-
tuberculosis
- INH:
-
isoniazid
- RIF:
-
Rifampicin
- EMB:
-
Ethambutol
- GOT:
-
glutamic oxaloacetic transaminase
- GPT:
-
gammaglutamyl transpeptidase
References
Byrd CRB, Horn BR, Solomon DA, Griggs GA (1979) Toxic effects of Isoniazid in tuberculous chemo profylaxis. JAMA 241:1239–1241
Casteels-Van Daele M, Igodt-Ameye L, Corbeel L, Eeckels R (1975) Hepatotoxicity of Rifampicin ands Isoniazid in children. J Pediatr 86:739–741
Grönhagen-Riska C, Hellström PE, Fröseth B (1978) Predisposing factors in hepatitis induced by Isoniazid-Rifampin treatment of tuberculosis. Am Rev Respir Dis 118:461–466
Grosset J, Lenventis S (1983) Adverse effects of Rifampin. Rev Infect Dis 5 [Suppl]: 5440–5446
Kendig EL (1983) Tuberculosis. In: Kendig EL, Chernick V (eds) Disorders of the respiratory tract in children, 4th edn. Saunders, Philadelphia, pp 662–702
Lesobre R, Ruffino J, Teyssier L, Achard F, Brefort G (1969) Les ictères au course du traitment par la rifampicin. Rev Tuberc Pneumol 33:393–403
Mitchell JR, Potter WZ, Hinson JA, Snodgrass WR, Timbrell JA, Gillette JR (1975) Toxic drug reactions. In: Gillette JR, Mitchell JR (eds) Handbook of experimental pharmacology. Springer, New York, pp 382–419
Nebout T, Dhumeaux D, Berthelot P (1974) Ictères et Rifampicine. Nouv Presse Med 3:733–736
Smith J, Tyrell WF, Gow A, Allan GB, Lees AW (1972) Hepatotoxicity in Rifampin-Isoniazid treated patients related to their rate of Isoniazid inactivation. Chest 61:587–588
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
van Aalderen, W.M.C., Knoester, H. & Knol, K. Fulminant hepatitis during treatment with Rifampicin, pyrazinamid and ethambutol. Eur J Pediatr 146, 290–291 (1987). https://doi.org/10.1007/BF00716476
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00716476