This is an unusual presentation where both hepatitis and psychosis due to isoniazid occurred together simultaneously. Key words: Isoniazid hepatitis, Isoniazid psychosis Advertisement Applied Medical Research SUBMIT YOUR ARTICLE NOW [scopemed.org]

Since this drug has been associated with hepatic dysfunction in adults, the present study was undertaken to evaluate its effect on liver function in teen-agers. [ncbi.nlm.nih.gov]

In the present study, transaminase values and anti-HCV status were similar among drinkers and nondrinkers. [natap.org]

Always consider drugs as a cause of any patient presenting with hepatitis in order to provide early effective management. [patient.info]

Mason, MD now presents the fifth edition in full color with new images and highlighted clinical elements. [books.google.com]

• Pain

  Signs of a pancreas problem ( pancreatitis ) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up. [drugs.com]

  Common side effects may include: red-orange coloration of tears, sweat, saliva, urine, or stools; numbness, tingling, itching, mild rash; drowsiness, dizziness, headache; muscle pain or weakness; heartburn, gas, diarrhea; or mouth pain. [uofmhealth.org]

  […] or tenderness Blurred vision or loss of vision, with or without eye pain Convulsions (seizures) Joint pain Mental depression Mood or other mental changes Common side effects: tingling of hands and feet nausea/vomiting/diarrhea This is not a complete [rxwiki.com]

  Seven patients initially experienced excess fatigue, nausea, or abdominal pain, but waited until the onset of jaundice before seeking medical attention. [cdc.gov]

  […] the risk of bleeding) Anemia High blood sugar levels in the blood Gynecomastia (enlargement of the breasts in men) Ringing in the ears Urinary retention (difficulty passing urine) Blood disorders Hypersensitivity reactions Painful joints What is the [medicinenet.com]

• Fatigue

  A prodromal period characterized by fatigue, weakness, anorexia, and malaise was noted in all patients before the appearance of jaundice. [annals.org]

  Seven patients initially experienced excess fatigue, nausea, or abdominal pain, but waited until the onset of jaundice before seeking medical attention. [cdc.gov]

  These include any of the following: unexplained anorexia, nausea, vomiting, dark urine, icterus, rash, persistent paresthesias of the hands and feet, persistant fatigue, weakness or fever of greater than 3 days duration and/or abdominal tenderness, especially [rxwiki.com]

  These symptoms and signs include: Unexplained loss of appetite Nausea Vomiting Dark urine Yellow skin or a yellowish tinge to the whites of the eyes Persistent fatigue Weakness Fever of greater than 3 days duration Abdominal tenderness or discomfort, [medicinenet.com]

  Patients should be instructed to report immediately any of the prodromal symptoms of hepatitis, such as fatigue, weakness, malaise, anorexia, nausea or vomiting. [rxmed.com]

• Anemia

  aplastic anemia, agranulocytosis, thrombocytopenia Hepatic: hepatitis Metabolic: pyridoxine deficiency, hyperglycemia, metabolic acidosis Respiratory: dyspnea Other: fever, pellagra, lupuslike syndrome, injection site irritation, hypersensitivity reaction [medical-dictionary.thefreedictionary.com]

  […] of isoniazid include: Nausea Vomiting Abdominal pain Dry skin Fever Skin rashes and eruptions Swollen lymph nodes Reductions in white blood cells (which increases the risk of infection) Reductions in platelets (which increases the risk of bleeding) Anemia [medicinenet.com]

  Hematologic: agranulocytosis, hemolytic, sideroblastic or aplastic anemia; thrombocytopenia; eosinophilia. Hypersensitivity: fever, skin eruptions (morbilliform, maculopapular, purpuric, or exfoliative), lymphadenopathy, vasculitis. [rxmed.com]

  Therefore, isoniazid-induced pyridoxine deficiency causes insufficient heme formation in early red blood cells, leading to sideroblastic anemia. [16] Drug interactions [ edit ] People taking isoniazid and acetaminophen are at risk of acetaminophen toxicity [en.wikipedia.org]

  Hematologic Reactions: Agranulocytosis ; hemolytic, sideroblastic or aplastic anemia, thrombocytopenia ; and eosinophilia. [wikidoc.org]

• Pathologist

  Reynolds, M.D., associate pathologist, Peter Bent Brigham Hospital, Boston, for a review of the slides. [nejm.org]

• Nausea

  Seven patients initially experienced excess fatigue, nausea, or abdominal pain, but waited until the onset of jaundice before seeking medical attention. [cdc.gov]

  Common side effects of Isoniazid include tingling of hands and feet, nausea, vomiting, and diarrhea. Do not drink alcohol while taking isoniazid. Alcohol may increase the risk of liver damage during isoniazid treatment. [rxwiki.com]

  Patients should be instructed to report immediately any of the prodromal symptoms of hepatitis, such as fatigue, weakness, malaise, anorexia, nausea or vomiting. [rxmed.com]

  Adverse Reactions: Peripheral neuropathy (esp. in slow acetylators), elevated serum transaminases (SGOT; SGPT), bilirubinemia, bilirubinuria, jaundice, hepatitis (may be fatal), nausea, vomiting, epigastric distress, pancreatitis, blood dyscrasias, hypersensitivity [clinicaladvisor.com]

  Adverse reactions CNS: peripheral neuropathy, dizziness, memory impairment, slurred speech, psychosis, toxic encephalopathy, seizures EENT: visual disturbances GI: nausea, vomiting GU: gynecomastia Hematologic: eosinophilia, methemoglobinemia, hemolytic [medical-dictionary.thefreedictionary.com]

• Vomiting

  Common side effects of Isoniazid include tingling of hands and feet, nausea, vomiting, and diarrhea. Do not drink alcohol while taking isoniazid. Alcohol may increase the risk of liver damage during isoniazid treatment. [rxwiki.com]

  Abstract A 22-year-old female who was a known case of tubercular meningitis on anti-tubercular therapy, presented to the emergency room with complaints of recurrent vomiting, markedly reduced appetite, yellowish discoloration of eyes, abnormal behaviour [scopemed.org]

  Medical providers should emphasize to patients that INH treatment should be stopped immediately upon the earliest onset of symptoms (e.g., excess fatigue, nausea, vomiting, abdominal pain, or jaundice), even before a clinical evaluation has been conducted [cdc.gov]

  Patients should be instructed to report immediately any of the prodromal symptoms of hepatitis, such as fatigue, weakness, malaise, anorexia, nausea or vomiting. [rxmed.com]

  Adverse Reactions: Peripheral neuropathy (esp. in slow acetylators), elevated serum transaminases (SGOT; SGPT), bilirubinemia, bilirubinuria, jaundice, hepatitis (may be fatal), nausea, vomiting, epigastric distress, pancreatitis, blood dyscrasias, hypersensitivity [clinicaladvisor.com]

• Hypertension

  Sickle trait positive, relapse cases, cases with extensive or miliary disease, COPD, asthma, Diabetes mellitus, hypertension… all were recruited in both the group, which may account for the higher incidence of hepatotoxicity in control group but at the [sciencedaily.com]

  Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015;63:743-52. Jalan R, Fernandez J, Wiest R, et al. [sapd.es]

  Foods containing tyramine: hypertensive crisis, other severe reactions Drug-behaviors. Alcohol use: increased risk of hepatitis Patient monitoring • Assess hepatic enzyme levels. • Watch for adverse reactions, such as peripheral neuropathy. [medical-dictionary.thefreedictionary.com]

  Occurrence with portal hypertension, hypoalbuminemia, and hypersplenism. JAMA 1979; 242: 353-4. [livertox.nih.gov]

• Heart Disease

  Safety and efficacy of long-term statin treatment for cardiovascular events in patients with coronary heart disease and abnormal liver tests in the Greek Atorvastatin and Coronary Heart Disease Evaluation (GREACE) Study: a post-hoc analysis. [gi.org]

• Jaundice

  However, jaundice was notably absent in the patients with enzyme elevations and prompted a further investigation into the possible effect of INH on bilirubin metabolism. Thus, Sprague-Dawley rats were given four daily injections of INH. [ncbi.nlm.nih.gov]

  A prodromal period characterized by fatigue, weakness, anorexia, and malaise was noted in all patients before the appearance of jaundice. [annals.org]

  and that initial symptoms can be subtle and might not include jaundice. [cdc.gov]

  ALTHOUGH isoniazid (INH) is thought to be a rare cause of jaundice its precise role is unclear. [nejm.org]

• Scleral Icterus

  AST ≥250 Karmen units or ALT>AST, and no other cause 13,838 92 (0.66%) 8 (0.06%) IUATCP 4 mid-1970s Every-4-week symptom-based screening Not defined 20,840 95 (0.5%) 3 (0.014%) Dash 4 Jan. 1973 to June 1977 Monthly symptom based screening Jaundice, scleral [mdedge.com]

• Pruritus

  Usually, the onset is abrupt, with chills, fever, rash, pruritus, arthralgia, headache, abdominal pain, anorexia, nausea and vomiting. Later, overt evidence of liver damage, such as jaundice, dark urine and an enlarged and tender liver, may develop. [patient.info]

  Hepatitis and liver dysfunction with rifampicin therapy for pruritus in primary biliary cirrhosis. Gut 2002;50:436-439. Kaplan MM, Bonder A, Ruthazer R, Bonis PA. [sapd.es]

  Most clinicians use antihistamines such as diphenhydramine and hydroxyzine for symptomatic pruritus. [gi.org]

  On presentation, she complained of fatigue, nausea and dark urine but denied fever, rash or pruritus. She had no previous history of liver disease and did not drink alcohol or take other medications or herbal products. [livertox.nih.gov]

• Dark Urine

  Side Effects of Isoniazid If you experience any of the following symptoms of liver damage, call your doctor immediately: excessive tiredness/weakness lack of energy loss of appetite upset stomach, vomiting dark urine yellowing of the skin or eyes Tell [rxwiki.com]

  urine for several days 1 146 107 Liver transplant 29 Eczema Rare concurrent alcohol consumption Fatigue, nausea for 2 weeks then icterus, dark urine and jaundice for several days 4 137 16 Death 35 HIV infection, chronic hepatitis C virus infection, eczema [cdc.gov]

  Later, overt evidence of liver damage, such as jaundice, dark urine and an enlarged and tender liver, may develop. Two general pathogenic mechanisms are recognised: Predictable or direct: usually promptly follows an exposure to a new medication. [patient.info]

  • Instruct patient to report anorexia, nausea, vomiting, jaundice, dark urine, and numbness or tingling of hands or feet. • Tell patient he'll need periodic medical and eye examinations and blood tests to gauge drug effects. • As appropriate, review [medical-dictionary.thefreedictionary.com]

  Dark colored urine can be a sign of liver problems. Call your doctor if you have reddish-brown urine together with upper stomach pain, loss of appetite, and jaundice (yellowing of your skin or eyes). [uofmhealth.org]

The efficacy of LTI treatment as a strategy in special-risk groups depends on the risk of developing active tuberculosis disease, the efficacy of the drugs used, and adherence to the treatment regimen. [natap.org]

Significant updates on bariatric surgery, Barrett's esophagus, endoscopic ultrasound, endosonography, treatment of liver disease, and much more keep you current on the latest advances. [books.google.com]

[…] modifying drug (DMARD) treatment in 88 patients (table 1). [ard.bmj.com]

[…] and treatment based on risk for infection. [cdc.gov]

The use of antiretroviral drugs at the time of initiating TB treatment was confirmed by consulting medical records and categorized as: not using HAART, initiated HAART before TB treatment and initiated HAART during the first two months of TB treatment [journals.plos.org]

O'Grady JG, Alexander GJM, Hayllar KM, Williams R: Early indicators of prognosis in fulminant hepatic failure. Gastroenterology 97:439–445, 1989 PubMed Google Scholar 13. CDC: Severe isoniazid-associated hepatitis—New York, 1991–1993. [link.springer.com]

When hepatic failure occurs, prognosis depends on early identification and correction of complications (eg, aspiration pneumonia, hypotension, and cardiopulmonary arrest). [emedicine.medscape.com]

The risk is higher in women. [ 6, 7 ] Prognosis Usually symptoms subside when the causative drug has been discontinued and drug-related hepatitis subsides within days or weeks after the offending drug is stopped. [patient.info]

The impact of eosinophilia and hepatic necrosis on prognosis in patients with drug-induced liver injury. Aliment Pharmacol Ther 2007;25:1411–1421. 36. Rochon J, Protiva P, Seeff LB et al. [gi.org]

The impact of eosinophilia and hepatic necrosis on prognosis in patients with drug-induced liver injury. Aliment Pharmacol Ther 2007; 25: 1411-21. [livertox.nih.gov]

Acute liver disease of any etiology. Warnings/Precautions: Increased risk of severe or fatal hepatitis; monitor, discontinue if signs of hepatic damage detected. Defer in acute hepatic disease. Alcoholics. Chronic liver disease. [clinicaladvisor.com]

[…] drug exposure varies from hours to months Clinical manifestations range from asymptomatic deranged liver function to fulminant hepatic failure and death Mimic all forms of acute, chronic, vascular or neoplastic liver diseases that are caused by other etiologies [pathologyoutlines.com]

This categorization allows testing for competing etiologies in a systematic approach. [gi.org]

Patients who develop severe hypersensitivity reactions to isoniazid, including drug-induced hepatitis; acute liver disease of any etiology. [rxmed.com]

Etiology Acute central nervous system (CNS) toxicity typically occurs in isoniazid (INH) overdose, but it may also be found with therapeutic use if administered in conjunction with rifampin, ethanol, barbiturates, and other CYP-450 inducers. [emedicine.medscape.com]

Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 49 (‎22)‎, 189 - 190. https://apps.who.int/iris/handle/10665/219888 Revista Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 49 (‎22)‎: 189 - 190 Documentos relacionados [apps.who.int]

Article navigation 1 Department of Epidemiology, The Bloomberg School of Public Health, Johns Hopkins University, Baltimore Search for other works by this author on: Pankaj Sadaphal 1 Department of Epidemiology, The Bloomberg School of Public Health, [academic.oup.com]

Aetiological aspects on primary liver cancer with special regard to alcohol, organic solvents and acute intermittent porphyria — An epidemiological investigation. ‎ Page 283 - Bressac, B., Kew, M., Wands, J., and Ozturk, M. 1991. [books.google.com]

Lavanchy D. hepatitis B virus epidemiology, disease burden, treatment and current and emerging prevention and control measures. J viral heap 2004;11:97-107. 75. Guan R. Epidemiology of hepatitis B infection in east and south east Asian countries. [hepatitisbannual.org]

Definition / general Drug / toxin reactions can be intrinsic or predictable, where they are dose dependent (e.g. acetaminophen ); or idiosyncratic and unpredictable, where they are dose independent (e.g. isoniazid) Pathophysiology Underlying mechanisms [pathologyoutlines.com]

Pathophysiology Acute toxicity Acute isoniazid (INH) overdose results in decreased pyridoxal-5'-phosphate levels, decreased gamma-aminobutyric acid (GABA) synthesis, increased cerebral excitability, and seizures. [emedicine.medscape.com]

Table 1 Demographic characteristics of 146 persons receiving isoniazid as preventive therapy. Table 1 Demographic characteristics of 146 persons receiving isoniazid as preventive therapy. [academic.oup.com]

Preventing people from contracting TB in high- risk areas is a goal worth pursuing. [cochrane.org]

Among 3,681 women treated with INH during and after pregnancy to prevent tuberculosis (TB), 5 developed INH hepatitis, and 2 of the 5 women died. [ncbi.nlm.nih.gov]

Preventive therapy of contacts causes severe hepatotoxicity more often than curative treatment of clinical tuberculosis. [sciencedaily.com]

Isoniazid, also called isonicotinic acid hydrazide (INH), drug used in the treatment and prevention of tuberculosis. [britannica.com]