Reintroduction regimens in anti-tubercular therapy-induced hepatitis in extra-pulmonary tuberculosis patients – A pilot study

Meena, Alpana; Daga, Mradul Kumar; Kar, Premashish

doi:10.1016/j.injms.2016.09.010

Cited by 2 publications

(2 citation statements)

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“…Kebanyakan obat antituberkulosis (OAT) berhubungan dengan hepatotoksisitas yang dapat menyebabkan morbiditas, mortalitas, dan mengurangi efektivitas OAT. 4 Hepatotoksisitas pada pasien TB paru sebesar 25,7%, pada TB ekstraparu 55,4%, dan 18,9% pada TB milier atau TB diseminata. 5 Kejadian drug induced hepatitis (DIH) pada kasus TB sulit diprediksi, penelitian melaporkan faktor risiko terjadinya DIH selama pemberian OAT yaitu: penyakit hati sebelumnya, khususnya terkait dengan infeksi virus kronis seperti hepatitis B, C, dan HIV, alkoholik, usia lanjut, dan malnutrisi.…”

Section: Pendahuluanunclassified

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Drug Induced Hepatitis pada Tuberkulosis Paru dengan Multisite Tuberkulosis Ekstraparu

Wesnawa

Kusmiati

2020

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Background: Tuberculosis (TB) continues to be a major health problem in developing country. Lung is the most common site for Mycobacterium tuberculosis (MTB) infection, but dissemination may occur to any part of the body resulting in extrapulmonary TB. Hepatotoxicity is one of the most frequent adverse events that occur during TB treatment. Case: A 35-year-old female patient came with cough, dyspnea, fever, abdominal pain, history of mass in right inguinal lymph node, and malnutrition. Histopathology from excisional biopsy of inguinal lymph node showed granulomatous inflammation. Computed tomography of abdomen showed intraabdominal TB. Chest X-ray showed right pleural effusion, with exudate pleural fluid and mononuclear dominant. After 1 week consuming antituberculous drug, patient got nausea and vommiting, increased of ALT and AST, total and direct bilirubin. Antituberculous drug was stopped and switched to levofloxacin, ethambutol, and streptomycin. After clinical improvement and liver function return to normal, desensitization of rifampicin and isoniazide was started. Desensitization started with rifampicin for three days, and followed with isoniazide for three days. In total, the patient got rifampicin, isoniazide, and ethambutol for 9 months. Evaluation of treatments are clinical improvement and weight gain. Acid fast baccili sputum was negatif, no pleural effusion on chest X-ray, and normal abdominal ultrasound. Conclusion: MTB can spread to other organs which cause multisite extrapulmonary TB. Side effect can occur during TB treament, and this is not the reason to stop the therapy. Individual ATD therapy shows good response in this case.

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Section: Pendahuluanunclassified

“…6,7 Terdapat pilihan regimen yang beragam dalam reintroduce OAT pada DIH, namun belum ada pedoman konsensus. 4 Belum ada data mengenai tingkat keparahan DIH pada TB paru dibanding dengan TB ekstraparu atau TB paru dengan TB ekstraparu. Berikut dilaporkan kasus DIH pada TB paru dengan multisite TB ekstraparu pada penderita perempuan.…”

Section: Pendahuluanunclassified

Drug Induced Hepatitis pada Tuberkulosis Paru dengan Multisite Tuberkulosis Ekstraparu

Wesnawa

Kusmiati

2020

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Risk of hepatitis with various reintroduction regimens of anti-tubercular therapy: a systematic review and network meta-analysis

Soni

Kumar‐M

Mishra

et al. 2020

Expert Review of Anti-infective Therapy

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Reintroduction regimens in anti-tubercular therapy-induced hepatitis in extra-pulmonary tuberculosis patients – A pilot study

Cited by 2 publications

References 20 publications

Drug Induced Hepatitis pada Tuberkulosis Paru dengan Multisite Tuberkulosis Ekstraparu

Drug Induced Hepatitis pada Tuberkulosis Paru dengan Multisite Tuberkulosis Ekstraparu

Risk of hepatitis with various reintroduction regimens of anti-tubercular therapy: a systematic review and network meta-analysis

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