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Hemalatha Selvaraj , Kumudha Dhamothrasamy , Kanagaraj Duraisamy , Muralikrishnan Dhanasekaran

Abstract

One of the most frequently used anti-tubercular medications, isoniazid, commonly referred to as Isonicotinic acid hydrazide, is an antibiotic for the treatment of tuberculosis (TB). A prodrug called isoniazid inhibits mycobacterial cellular structures from developing. Isoniazid activation necessitates the presence of KatG, a bacterial catalase-peroxidase enzyme present in Mycobacterium tuberculosis. Since the liver plays a significant role in the metabolism and detoxification of drugs, it is subsequently susceptible to damage. Hepatotoxicity caused by anti-TB medicines has been documented in 5–28 % of patients who have been treated with anti-TB drugs. In this case, pulmonary tuberculosis was detected in the 43-year-old patient, who was started on ATT category I treatment one month. After a few days, his liver parameters were elevated. Assessment of ADR was revealed by the dechallenging of drugs viz., Ethambutol, Pyrazinamide, Rifampicin, and Isoniazid. When it was discovered that isoniazid caused hepatotoxicity, the drug was withdrawn and the patient was prescribed a RESO regimen. The Naranjo probability scale was utilized to assess the adverse drug effects, and the resultant score “probable” most likely indicated that anti-TB medicines induce hepatotoxicity. This article talks about a case of hepatotoxicity caused by isoniazid, how it was treated, and why the anti-tuberculosis treatment plan had to be changed‎.

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