Drug induced liver injury due to anti tuberculous chemotherapy in directly observed daily therapy in fifty patients : a retrospective study in Western India
Journal Title: Journal of the Indian Medical Association - Year 2019, Vol 117, Issue 5
Abstract
Drug induced liver injury (DILI) is the most common adverse drug reaction leading to interruption of treatment in tuberculosis (TB). There are limited guidelines and treatment strategies on DILI due to anti TB drugs. (1) To study whether rapid reintroduction of drugs in DILI has any adverse outcome. (2) Rates of recurrent drug induced hepatitis. (3) Does DILI predispose a patient for drug resistant TB. Case record forms (CRFs) of 2113 patients were analyzed for the incidence of DILI. A total of 148 patients were diagnosed with hepatotoxicity and after careful exclusion 50 patients were diagnosed with DILI. All patients were reintroduced with all the drugs together once the hepatitis was resolved. A written informed consent was taken. Incidence of hepatotoxicity was 7%. Incidence of DILI was 2.4%. Female predominance was seen (68%). Majority of patients were suffering from pulmonary TB (72%). A mean of 14.2 days were lost before reintroduction. Recurrent DILI was seen in ten percent of patients (n=5). Six patients developed drug resistant tuberculosis due to interruption of treatment. (p value 0.031). Rapid reintroduction of drugs was well tolerated with recurrence rates of 10%. DILI predisposes a patient to develop MDR TB
Authors and Affiliations
Subramanian Natarajan, Poonam Subramanian
Keywords
Related Articles
- EP ID EP626260
- DOI -
- Views 132
- Downloads 0
Guideline based management of community acquired pneumonia
Pneumonia is a common clinical condition confronted by general practitioners as well as chest physicians1. The annual incidence varies in different age groups. It is common in children aged <5 years and in elderly people...
The right to euglycemia; the responsibility for glucophylaxis
Every Indian citizen enjoys the right to life, and to health. These rights, enshrined in our constitution, form the bed rock of our national vision and philosophy. In their endeavor to fulfil these obligations, public he...
Late onset treatable neurological diseases
Consecutive Indian census data have shown increasing aging population above 60 years of age from 7.5% in 2001 to 8.0% in 2011. Though in percentage term there is small increase of aging population, but in absolute term i...
Determination of safe anti-tubercular therapy regimen following anti-tubercular drug induced hepatitis in patients with active tuberculosis
To determine the safety of restarting isoniazid and rifampicin and etambutol or isoniazid pyrazinamid and ethambutol in patients who develop antitubercular drug induced hepatitis. In 22 tuberculosis patients, who develop...
Oculo-auricular-fronto-nasal syndrome a new entity
We describe a unique combination of fronto nasal malformations and oculo auricular vertebral syndrome without any vertebral defects and with bilateral involvement of eyes. The oculo auricular vertebral syndrome manifests...