ANTI-TUBERCULAR DRUGS INDUCED HEPATOTOXICITY- A CASE REPORT

Araveti Lokesh, Y. Grace Nithya*, Shaik Fouzia, Sangaraju Vijayalakshmi and Meda Venkata Subbaiah

ABSTRACT

First line anti-tubercular drugs like Isoniazide (10-20%), Rifampicin (10-15%) and Pyrazinamide are potentially hepatotoxic drugs but in case of Ethambutol and Streptomycin are less hepatotoxic drugs. The incidence rate of this adverse effect is found to be 2% to 28%. This is a case report on severe adverse effect focusing on 55 years male patient who brought to hospital with the complaints of abdominal pain which is aggravated and relieving but not of radiating type. Patient is known tubercular from 4 months on regular treatment i.e. Isoniazide, Rifampicin, Pyrazinamide, ethambutol and streptomycin thrice in a week. Based on laboratory and USG abdomen of the patient, he was diagnosed with ATT induced hepatotoxicity through causality assessment. In the management of adverse reaction symptomatic treatment is given and tubercular therapy was altered with Levofloxacin, ethambutol and streptomycin. To prevent and/ minimize drug induced complications and for better management we need to monitor the vitals and systems at risk at regular intervals during therapy.

Keywords: Anti-tubercular drugs, causality assessment, adverse reaction, hepatotoxicity.