Isoniazid toxicity presenting as status epilepticus and severe metabolic acidosis.
Isoniazid (INH) is an integral component of treatment of tuberculosis. An acute overdose is potentially fatal and is characterized by the clinical triad of repetitive seizures unresponsive to the usual anticonvulsants, metabolic acidosis with a high anion gap and coma. The diagnosis of INH overdose should be considered in any patient who presents to emergency medical services (EMS) with the triad. We report a patient presenting with multiple generalised tonic clonic (GTC) convulsions with severe metabolic acidosis as a manifestation of INH toxicity.
Gokhale
Yojana A
YA
Department of Internal Medicine, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai - 400 022.
Vaidya
Meghna S
MS
Mehta
A D
AD
Rathod
N N
NN
D000138:Acidosis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D000328:Adult; D000995:Antitubercular Agents / Q000009:adverse effects*; D001639:Bicarbonates / Q000008:administration & dosage / Q000627:therapeutic use; D002021:Buffers; D004234:Diuretics, Osmotic / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects*; D008353:Mannitol / Q000008:administration & dosage / Q000627:therapeutic use; D011736:Pyridoxine / Q000008:administration & dosage / Q000627:therapeutic use; D013226:Status Epilepticus / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D014803:Vitamin B Complex / Q000008:administration & dosage / Q000627:therapeutic use
D000995:Antitubercular Agents; D001639:Bicarbonates; D002021:Buffers; D004234:Diuretics, Osmotic; D014803:Vitamin B Complex; D008353:Mannitol; D011736:Pyridoxine; D007538:Isoniazid