Isoniazid-induced hyperacute liver failure in a young patient receiving carbamazepine.
A 16-year-old female under long-term carbamazepine and clobazam therapy developed fulminant liver failure after initiating therapy with isoniazid, rifampin, and pirazinamide for intestinal tuberculosis. Liver failure was hyperacute (with a minimal interval between jaundice and encephalopathy) and occurred very shortly (5 days) after the start of antituberculous therapy. The patient recovered completely with conservative measures. Later, she tolerated carbamazepine, clobazam, rifampin, and pirazinamide without problems, thus confirming that liver failure was isoniazid-induced. Drug interaction between isoniazid and carbamazepine could explain the atypical presentation of this case.
Campos-Franco
J
J
Department of Internal Medicine, Hospital Clínico Universitario, c/ Choupana sn, 15706 Santiago de Compostela, Spain.
González-Quintela
A
A
Alende-Sixto
M R
MR