Acute Isoniazid Intoxication: Seizures, Acidosis And Coma

Temmerman, W; Dhondt, Annemieke; Vandewoude, K

doi:10.1080/17843286.1999.11754234

Cited by 39 publications

(29 citation statements)

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“…In the present case, a deficiency of vitamin B6 was regarded to be the cause of the patient's convulsive seizures because the serum vitamin B6 level on admission was low. Similar to that observed in previously reported cases, the seizures in our case were refractory to anticonvulsant therapy (11). The rate of production of GABA is influenced by the level of pyridoxal 5' phosphate.…”

Section: Discussionsupporting

confidence: 77%

Convulsive Seizures with a Therapeutic Dose of Isoniazid

et al. 2014

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An 86-year-old woman who had been treated for tuberculous peritonitis and pulmonary tuberculosis, exhibited a disturbance of consciousness and tonic-clonic convulsions seven days after the administration of the antituberculous drug isoniazid. As her serum vitamin B6 level was remarkably low, she was diagnosed with convulsive seizures due to vitamin B6 deficiency associated with isoniazid treatment. Seizures refractory to standard anticonvulsant therapy were controlled with the administration of pyridoxine. Most reported cases of isoniazid-induced convulsive seizures occurred as a result of an overdose due to attempted suicide. This report presents a case of convulsive seizures that occurred in association with the short-term administration of a therapeutic dose of isoniazid.

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Section: Discussionsupporting

confidence: 77%

Convulsive Seizures with a Therapeutic Dose of Isoniazid

et al. 2014

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“…4 Using a search of PubMed (in February 2008) we found only three reports of INH-induced coma treated with hemodialysis and pyridoxine. [5][6][7] In our case report the patient ingested 196 mg/kg INH (12 g per 61 kg), which is much higher than the lethal dosage (80 mg/kg). Fortunately the patient was found comatose by his wife and hospitalized within 2 hours of ingestion.…”

Section: Discussionmentioning

confidence: 81%

Coma caused by isoniazid poisoning in a patient treated with pyridoxine and hemodialysis

Tai

Hui

2008

Adv Therapy

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Isoniazid is widely used to treat tuberculosis. In populations with a high prevalence rate of tuberculosis, acute ingestion of isoniazid has been reported as a potential cause of coma. In this study, we present the diagnosis and treatment of isoniazid poisoning in a case with acute coma as the major clinical presentation.A 32-year-old male who ingested 12 g isoniazid (2 hours prior to medical attention) was brought to the emergency department while in a coma and experiencing frequent seizures. Initial treatment with large doses of pyridoxine (for 6 hours) failed to awaken this patient. The patient was then given hemodialysis and pyridoxine; after 3 days he awoke from coma, with no further reported seizures.Isoniazid poisoning should be suspected in patients whose major symptoms are coma and seizure, especially those who have access to isoniazid. Monitoring the blood level of isoniazid will establish the diagnosis and help clinical management. A combination of hemodialysis and pyridoxine is effective in treating isoniazid poisoning.

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“…Pyridoxine is the antidote and has been shown to reverse coma, as well as terminate and prevent seizure activity. It should be administered in a milligram-to-milligram dose based on the amount ingested (22). If the amount of isoniazid ingested is unknown, 5 g of pyridoxine should be given over 3 to 5 minutes and may be followed by an additional 5 g in 30 minutes.…”

Section: Casementioning

confidence: 99%