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2000
Volume 25, Issue 1
  • ISSN: 1871-5265
  • E-ISSN: 2212-3989

Abstract

Background

Tuberculosis is still one of the biggest causes of infection-related death around the world. Disseminated tuberculosis is a potentially fatal disease caused by the haematogenous spread of . First-line anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide, and ethambutol. The first three drugs are known to cause hepatotoxicity.

Case Presentation

We have, herein, reported a case of Drug-induced Liver Injury (DILI) due to anti-tuberculosis therapy in a one-year-old male child with disseminated tuberculosis. He was started on a fixed-dose combination of Anti-tuberculosis Therapy (ATT; isoniazid 50 mg, rifampicin 75 mg, and pyrazinamide 150 mg) and pyridoxine 10 mg orally. Initially, liver parameters were normal, but later on with the course of the treatment, there was a rapid rise in liver enzymes, suggesting liver injury.

Discussion

The association between liver injury and anti-tuberculosis therapy has been confirmed by applying various causality association scales. It is obvious that proper treatment of disseminated tuberculosis can avoid the development of drug-resistant strains that can be harmful, worsening the prognosis as there are fewer therapeutic alternatives available. At the same time, there is a need to monitor the patient with ATT-induced DILI.

Conclusion

The diagnosis of tuberculosis in children is difficult because of the mild, nonspecific clinical presentation, which usually reflects the implicated underlying organ. In addition to prompt diagnosis and treatment of disseminated TB, careful monitoring is equally important.

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2024-04-19
2025-01-11
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References

  1. VelayatiA.A. Tuberculosis in children.Int. J. Mycobacteriol.20165S1S1S210.1016/j.ijmyco.2016.10.038 28043486
    [Google Scholar]
  2. KhanF.Y. DosaK. FuadA. IbrahimW. AlainiA. OsmanL. Disseminated tuberculosis among adult patients admitted to Hamad general hospital, Qatar: A five year hospital based study.Mycobact. Dis.20166212
    [Google Scholar]
  3. SalemB. Disseminated tuberculosis following the placement of ureteral stents: A case repot.Cases J.20081138310.1186/1757‑1626‑1‑383 19077197
    [Google Scholar]
  4. DidelS. PurohitA. VyasV. KumarP. Disseminated tuberculosis in children—a difficult diagnose depends on how far we can go.BMJ Case Rep.20201312e23719210.1136/bcr‑2020‑237192 33318245
    [Google Scholar]
  5. YaoD.C. SartorisD.J. Musculoskeletal tuberculosis.Radiol. Clin. North Am.199533467968910.1016/S0033‑8389(22)00612‑1 7610238
    [Google Scholar]
  6. ShanleyD.J. Tuberculosis of the spine: Imaging features.AJR Am. J. Roentgenol.1995164365966410.2214/ajr.164.3.7863889 7863889
    [Google Scholar]
  7. ZhaoH. WangY. ZhangT. WangQ. XieW. Drug-induced liver injury from anti-tuberculosis treatment: A retrospective cohort study.Med. Sci. Monit.202026e92035010.12659/MSM.920350 32145061
    [Google Scholar]
  8. AnsariS. AmanullahM.F. RauniyarR.K. AhmadK. Pott′s spine: Diagnostic imaging modalities and technology advancements.N. Am. J. Med. Sci.20135740441110.4103/1947‑2714.115775 24020048
    [Google Scholar]
  9. BenzagmoutM. BoujrafS. ChakourK. ChaouiM.F. Pott′s disease in children.Surg. Neurol. Int.201121110.4103/2152‑7806.75459 21297923
    [Google Scholar]
  10. AbbaraA. ChittyS. RoeJ.K. Drug-induced liver injury from antituberculous treatment: A retrospective study from a large TB centre in the UK.BMC Infect. Dis.201717123110.1186/s12879‑017‑2330‑z 28340562
    [Google Scholar]
  11. FatimaS. KumariA. DasG. DwivediV.P. Tuberculosis vaccine: A journey from BCG to present.Life Sci.202025211759410.1016/j.lfs.2020.117594 32305522
    [Google Scholar]
  12. NataliD. CloatreG. BrossetC. What pulmonologists need to know about extrapulmonary tuberculosis.Breathe202016420021610.1183/20734735.0216‑2020 33664835
    [Google Scholar]
  13. SharmaS.K. MohanA. SharmaA. MitraD.K. Miliary tuberculosis: New insights into an old disease.Lancet Infect. Dis.20055741543010.1016/S1473‑3099(05)70163‑8 15978528
    [Google Scholar]
  14. SotgiuG. CentisR. D’ambrosioL. MiglioriG.B. Tuberculosis treatment and drug regimens.Cold Spring Harb. Perspect. Med.201555a01782210.1101/cshperspect.a017822
    [Google Scholar]
  15. YeeD. ValiquetteC. PelletierM. ParisienI. RocherI. MenziesD. Incidence of serious side effects from first-line antituberculosis drugs among patients treated for active tuberculosis.Am. J. Respir. Crit. Care Med.2003167111472147710.1164/rccm.200206‑626OC 12569078
    [Google Scholar]
  16. MarzukiO.A. FauziA.R. AyoubS. ImranK.M. Prevalence and risk factors of anti-tuberculosis drug-induced hepatitis in Malaysia.Singapore Med. J.2008499688693 18830542
    [Google Scholar]
  17. MollaY. WubetuM. DessieB. Anti-tuberculosis drug induced hepatotoxicity and associated factors among tuberculosis patients at selected hospitals, ethiopia.Hepat. Med.20211318
    [Google Scholar]
  18. ChangT.E. HuangY.S. ChangC.H. PerngC.L. HuangY.H. HouM.C. The susceptibility of anti-tuberculosis drug-induced liver injury and chronic hepatitis C infection: A systematic review and meta-analysis.J. Chin. Med. Assoc.201881211111810.1016/j.jcma.2017.10.002 29198550
    [Google Scholar]
  19. ZhangM. WangS. WilffertB. The association between the NAT2 genetic polymorphisms and risk of DILI during anti‐TB treatment: A systematic review and meta‐analysis.Br. J. Clin. Pharmacol.201884122747276010.1111/bcp.13722 30047605
    [Google Scholar]
  20. BlumbergH.M. BurmanW.J. ChaissonR.E. American thoracic society/centers for disease control and prevention/infectious diseases society of America.Am. J. Respir. Crit. Care Med.2003167460366210.1164/rccm.167.4.603 12588714
    [Google Scholar]
  21. AithalG.P. WatkinsP.B. AndradeR.J. Case definition and phenotype standardization in drug-induced liver injury.Clin. Pharmacol. Ther.201189680681510.1038/clpt.2011.58 21544079
    [Google Scholar]
  22. BouazziO.E. HammiS. BourkadiJ.E. First line anti-tuberculosis induced hepatotoxicity: Incidence and risk factors.Pan Afr. Med. J.20162516710.11604/pamj.2016.25.167.10060
    [Google Scholar]
  23. AminyR.Z. KholiliU. Anti-tuberculosis drug-induced liver injury in patient with hepatitis B and cirrhosis: A case report.Ann. Med. Surg.20228010415410.1016/j.amsu.2022.104154
    [Google Scholar]
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