Reactions 1704, p212 - 2 Jun 2018 Hepatotoxicity and widespread arthralgias: case report A 61-year-old woman developed hepatotoxicity during treatment with isoniazid and widespread arthralgias during treatment with pyrazinamide for cutaneous infection of Mycobacterium tuberculosis [routes not stated]. The woman presented with a solitary large black nodular lesion overlying her right proximal interphalangeal joint on her index finger since last one year. Considering a possibility of mycobacterial infection, she was empirically treated with anti- mycobacterial therapy, which consisted of isoniazid 300 mg/day, rifampicin, ethambutol, pyrazinamide 1.5 g/day and pyridoxine. It was later confirmed that she had Mycobacterium tuberculosis infection. A clinical response was obtained, however, she subsequently developed isoniazid- induced hepatotoxicity and widespread arthralgias [durations of treatments to reactions onsets not stated]. It was suspected that the arthralgia was secondary to pyrazinamide. The woman’s isoniazid and pyrazinamide therapies were consequently stopped, and the anti-tuberculous therapy was switched to moxifloxacin and clarithromycin [outcomes not stated]. Author comment: "Despite a clinical response, isoniazid was ceased secondary to isoniazid-induced hepatotoxicity, pyrazinamide was ceased due to widespread arthralgias." Laidler N. Cutaneous infection with paucibacillary mycobacterium tuberculosis treated successfully with a modified antituberculous drug regimen. Australasian Journal of Dermatology 59 (Suppl. 1): 80 (plus poster), 27 Apr 2018. Available from: URL: https://doi.org/10.1111/ajd.17_12815 [abstract] - Australia 803323609 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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