HEPATITIS INDUCED BY ANTI-TUBERCULAR THERAPY AND CHRONIC ALCOHOLISM: A CASE REPORT
Anti-tubercular drugs induced hepatotoxicity, which is a serious problem and it was reported that worldwide 2-32% of TB patients experience drug induced hepatotoxicity (DIH) during the course of the treatment. A 65 year old male, 47 kg weight and chronic alcoholic was brought to a tertiary care hospital in semi-conscious condition with chief complains of vomiting, cough with expectoration, loss of appetite, shortness of breath, fever (on & off) since 4 days. He had a history of smear positive pulmonary koch’s 10 days back and was taking regular first line anti-tubercular drug therapy (Isoniazid, Rifampicin, Pyrazinamide and Ethambutol). In this case, the patient was also chronic alcohol consumer and a known case of chronic obstructive pulmonary disease (COPD) since 2 years. After 10 days of anti-tubercular drug therapy, patient was found to develop hepatotoxicity with the findings of elevated total bilirubin and liver enzymes level. Viral markers for hepatitis, including hepatitis B viruses (HBV), hepatitis C viruses (HCV), human immunodeficiency virus (HIV), were all are non-reactive. Physician found provisional diagnosis of anti-tubercular drugs with alcohol induced hepatitis. Patient was on hold of previous anti-tubercular drugs therapy. Although it was started modified anti-tubercular drugs (Streptomycin, Levofloxacin, Ethambutol) therapy along with liver tonics. Upon normalization of patient conditions, physician started first line anti-tubercular drug therapy containing Rifampicin, Isoniazid, Pyrazinamide, Ethambutol and Pyridoxine with continued liver tonics. Routine monitoring of liver enzymes, total bilirubin were followed up till discharged. Such type of case studies with confirmed pulmonary koch’s conditions suggested to follow alcohol withdrawal with standard treatment and standard care to achieve a favorable outcome.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).