Pub Date : 2024-04-19DOI: 10.2174/0118715265287146240405075930
Hemasri Velmurugan, Krishnapriya Neelambaran, M. Gurunthalingam, Dushyant Chouhan, P. Thangaraju, Bikram Keshari Kar, N. R. Gaikwad
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 Mycobacterium tuberculosis. First-line anti-tuberculosis drugs in-clude 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 pa-rameters 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 con-firmed 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 harm-ful, 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, nonspe-cific clinical presentation, which usually reflects the implicated underlying organ. In addition to prompt diagnosis and treatment of disseminated TB, careful monitoring is equally important.
背景肺结核仍然是全世界与感染相关死亡的最大原因之一。播散性结核病是由结核分枝杆菌经血液传播引起的一种潜在致命疾病。一线抗结核药物包括异烟肼、利福平、吡嗪酰胺和乙胺丁醇。我们在此报告了一例因抗结核治疗导致药物性肝损伤(DILI)的病例,患者是一名患有播散性结核病的一岁男童。他开始口服固定剂量的抗结核疗法(ATT;异烟肼 50 毫克、利福平 75 毫克和吡嗪酰胺 150 毫克)和吡哆醇 10 毫克。最初,肝脏指标正常,但后来随着治疗的进行,肝酶迅速上升,提示肝损伤。显而易见,对播散性结核病的适当治疗可以避免耐药菌株的产生,而耐药菌株可能会对人体造成伤害,并由于可供选择的治疗方法较少而使预后恶化。同时,有必要对 ATT 引起的 DILI 患者进行监测。结论:由于临床表现轻微、无特异性,儿童结核病的诊断非常困难,这通常反映了受影响的潜在器官。除了及时诊断和治疗播散性肺结核外,仔细监测也同样重要。
{"title":"Vigilance Needed in Treating a Child with Disseminated TB: A Case Report.","authors":"Hemasri Velmurugan, Krishnapriya Neelambaran, M. Gurunthalingam, Dushyant Chouhan, P. Thangaraju, Bikram Keshari Kar, N. R. Gaikwad","doi":"10.2174/0118715265287146240405075930","DOIUrl":"https://doi.org/10.2174/0118715265287146240405075930","url":null,"abstract":"BACKGROUND\u0000Tuberculosis 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 Mycobacterium tuberculosis. First-line anti-tuberculosis drugs in-clude isoniazid, rifampicin, pyrazinamide, and ethambutol. The first three drugs are known to cause hepatotoxicity.\u0000\u0000\u0000CASE PRESENTATION\u0000We 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 pa-rameters were normal, but later on with the course of the treatment, there was a rapid rise in liver enzymes, suggesting liver injury.\u0000\u0000\u0000DISCUSSION\u0000The association between liver injury and anti-tuberculosis therapy has been con-firmed 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 harm-ful, 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.\u0000\u0000\u0000CONCLUSION\u0000The diagnosis of tuberculosis in children is difficult because of the mild, nonspe-cific clinical presentation, which usually reflects the implicated underlying organ. In addition to prompt diagnosis and treatment of disseminated TB, careful monitoring is equally important.","PeriodicalId":13678,"journal":{"name":"Infectious disorders drug targets","volume":" 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140683498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}