Hepatotoxicity after a short course of low-dose pyrazinamide.
We report on a patient who developed extensive centrolobular liver necrosis after a treatment with low-dose (25 mg/kg/d) pyrazinamide for only 4 weeks, combined with rifampicin, 600 mg/d). In the past, the patient already developed severe aminotransferase elevations under isoniazid treatment. After prompt withdrawal of the drugs, a gradual decline of the aminotransferases was observed. No signs of hepatic failure developed. Pyrazinamide has to be used with caution, even in low-dose, especially when combined with rifampicin.
al Sarraf
K A
KA
Division of Gastroenterology, University of Antwerp (U.I.A.), Belgium.
Michielsen
P P
PP
Hauben
E I
EI
Lefebure
A
A
Ramon
A M
AM
Van Marck
E A
EA
Pelckmans
P A
PA
D000328:Adult; D000995:Antitubercular Agents / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D004359:Drug Therapy, Combination; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D011718:Pyrazinamide / Q000008:administration & dosage / Q000009:adverse effects*; D012293:Rifampin / Q000008:administration & dosage
D000995:Antitubercular Agents; D011718:Pyrazinamide; D012293:Rifampin