Unintended consequences: mandatory tuberculin skin testing and severe isoniazid hepatotoxicity.
After mandatory school-enrollment tuberculin skin testing, a 4-year-old girl who was at low risk for Mycobacterium tuberculosis infection had severe isoniazid hepatotoxicity that was managed with a liver transplant. Although severe isoniazid hepatotoxicity is very uncommon in children, this case emphasizes the need to limit skin testing to persons who have a risk factor for infection and to educate parents on how to monitor for adverse effects during treatment.
Lobato
Mark N
MN
Connecticut Department of Public Health, 410 Capitol Ave, MS 11-TUB, PO Box 340308, Hartford, CT 06134, USA. mark.lobato@ct.gov
Jereb
John A
JA
Starke
Jeffrey R
JR
D000995:Antitubercular Agents / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects*; D014374:Tuberculin Test
D000995:Antitubercular Agents; D007538:Isoniazid