Paradoxical pleural response to antituberculous chemotherapy and isoniazid-induced lupus. Review and report of two cases.
Among 28 inpatients receiving antituberculous chemotherapies including isoniazid (INH) and rifampicin, we found 2 patients with newly developing pleural effusion in the hemithorax during the initial phase of successful chemotherapy. The analysis of the effusion fluids revealed an elevated level of antinuclear antibody and a decreased level of total component, which are findings compatible with lupus pleuritis. The peripheral lymphocyte stimulation test using INH was positive in 1 patient. To the best of our knowledge, there has been no published discussion of the relationship between a paradoxical response to antituberculous treatment and INH-induced lupus.
Hiraoka
K
K
Division of Respiratory Medicine, Chuba Rosai Hospital, Nagoya, Japan.
Nagata
N
N
Kawajiri
T
T
Suzuki
K
K
Kurokawa
S
S
Kido
M
M
Sakamoto
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects*; D008177:Lupus Vulgaris / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000187:drug effects*; D010996:Pleural Effusion / Q000139:chemically induced* / Q000000981:diagnostic imaging; D010998:Pleurisy / Q000139:chemically induced; D013902:Radiography, Thoracic
D000995:Antitubercular Agents; D007538:Isoniazid