Histologically proven isoniazid hepatoxicity in complicated tuberculous salpingitis.
Isoniazid (INH) hepatic injury is histologically indistinguishable from viral hepatitis and is related to individual susceptibility of patients who hydrolyze the drug to isonicotinic acid at different rates. We here present a case initially involving a complaint of lower abdominal pain, which was diagnosed after a long diagnostic work-up as tuberculous salpingitis and which is rare in women in developed countries. A lack of pulmonary effects further delayed correct diagnosis of the underlying tuberculosis infection. Based on the clinical follow up and liver histology, INH-induced severe hepatoxicity, which further contributed to the abdominal symptoms, could be confirmed. After adaptation of the standard therapeutic regimen no further complications occurred.
Semfke
Almut
A
St George Medical Centre, Robert-Koch-Hospital, Leipzig, Germany.
Wackernagel
Cornelia
C
Vier
Hannelore
H
Schütz
Alexander
A
Wiechmann
Volker
V
Gillissen
Adrian
A
D015746:Abdominal Pain / Q000209:etiology; D000995:Antitubercular Agents / Q000009:adverse effects* / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D012488:Salpingitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D012720:Severity of Illness Index; D013997:Time Factors; D014384:Tuberculosis, Female Genital / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology
D000995:Antitubercular Agents; D007538:Isoniazid