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Fever induced by isoniazid  [PDF]
Pinar Tosun Tasar, Sevnaz Sahin, Niyazi Bozkurt, Abdullah Say?ner, Soner Duman, Fehmi Akcicek
Advances in Aging Research (AAR) , 2014, DOI: 10.4236/aar.2014.31010

Isoniazid is the most important antituberculosis medicine. Adverse effects are generally fever and rash. There are few case reports in the literature which identified high fever without rash associated with INH use. In this case report, we present a case with tuberculosis lymphadenitis and isoniazid-induced fever.

Random amplified polymorphic DNA analysis of Mycobacterium tuberculosis isolates resistant to Isoniazid in Indonesia  [PDF]
Asaad Maidin, Agnes Lidjaja, Mochammad Hatta
Journal of Tuberculosis Research (JTR) , 2013, DOI: 10.4236/jtr.2013.12003
Abstract: Background: M. tuberculosisis the most important etiological factor of tuberculosis. One of the factors that make TB hard to eradicate is the emergence of M. tuberculosisdrug resistance. Drug resistance in M. tuberculosisis attributed primarily to the accumulation of mutations in the drug target gene. Objectives: to analyze profile of Random Amplified Polymorphic DNA (RAPD) in M. tuberculosisisolates resistant to Isoniazid and found RAPD marker. Methods: seven Isoniazid resistant isolate of M. tuberculosisfrom Ma kassar, Indonesia strain were analyzed by RAPD method using primers OPN 02, OPN 09, OPN 20, BG 65, N 9, that amplification fragment DNA than as molecular marker. Results: The results of the present study showed high degree of polymerphism in theM.tuberculosisstrains in the population, and found that specific DNA fragment at Isoniazid resistant isolates using primer N 9 is 1450 bp as a marker. Conclusion: This study gives information about RAPD marker of M. tuberculosis strain to Isoniazid resistant.

Isoniazid Preventive Therapy Associated Hepatotoxicity among Children Living with HIV: Descriptive Case Series at Mildmay Uganda HIV/AIDS Clinic, Uganda  [PDF]
Lawrence Nsobya, Henry Nsobya, Jane Nakaweesi, Esther Kawuma, Mary Odiit, Yvonne Karamagi, Barbara Mukasa
International Journal of Clinical Medicine (IJCM) , 2015, DOI: 10.4236/ijcm.2015.66050
Provision of Isoniazid Preventive Therapy (IPT) as part of the comprehensive TB/HIV prevention intervention for people living with HIV & AIDS was recommended by WHO in 2011. Literature shows that Isoniazid (INH) associated hepatotoxicity is a common drug adverse event among people taking INH, and that it’s associated with a high risk of mortality. These case series document INH associated hepatotoxicity in HIV-infected children receiving IPT in a resource constrained setting. They also further describe the challenges and lessons learnt while providing routine IPT among HIV-infected children in a resource-limited setting where laboratory tests for liver function monitoring are not performed routinely. The case series describe observed cases which presented to the Mildmay Uganda HIV/AIDS clinic between December 2013 and March 2014. The findings demonstrate that: 1) there was a 1.5% INH related hepatotoxicity incidence among children of four to ten years old; 2) 20% death rate—one out of the five children died and; 3) hepatotoxicity events on average occurred at 10.8 weeks after INH initiation while at the same time, all the cases had liver enzymes elevated above 10 times the upper normal limit values and reported late for medical intervention. The insidious onset of symptoms and signs of INH related hepatotoxicity coupled with lack of adequate resources needed to manage the condition were the major challenges to provision of routine IPT among children living with HIV in resource-limited settings in sub-Sahara Africa. Clinical vigilance, continuous education of clients and caretakers about the side effects or adverse events of INH and routine laboratory examination of liver function tests during follow-up of IPT in HIV-infected children are recommended to enhance early detection and prompt management of IPT associated hepatotoxicity.
Fatores associados ao abandono da quimioprofilaxia de TB no município de Vitória (ES): um estudo de coorte histórica
Maciel, Ethel Leonor Noia;Brioschi, Ana Paula;Guidoni, Letícia Molino;Cerqueira, Anne Caroline Barbosa;Prado, Thiago Nascimento do;Fregona, Geisa;Dietze, Reynaldo;
Jornal Brasileiro de Pneumologia , 2009, DOI: 10.1590/S1806-37132009000900010
Abstract: objective: to describe the factors associated with nonadherence to tb chemoprophylaxis in patients older than 15 years of age treated via referral tb control programs. methods: a historical cohort study was carried out based on medical charts related to cases treated via referral tb control programs in the city of vitória, brazil, between 2002 and 2007. cases of infection with mycobacterium tuberculosis were stratified into two groups: health care workers (hcw group); and individuals who were not health care workers (nhcw group). results: a total of 395 patients were included in the study: 35 in the hcw group and 360 in the nhcw group. the mean age in the hcw and nhcw groups was 34.8 and 32.4 years, respectively (p = 0.36). of the 35 patients in the hcw group, 29 (82.9%) were female, compared with 180 (50.0%) of the 360 patients in the nhcw group. in the hcw and nhcw groups, respectively, 15 (42.9%) and 169 (46.9%) of the patients were contacts of tb cases. in addition, 9 (25.7%) and 157 (78.5%) the hcw and nhcw group patients, respectively, were hiv-infected. nonadherence to chemoprophylaxis was 37.1% and 21.9% in the hcw and nhcw groups, respectively (p = 0.045). in the multivariate analysis, the factors associated with nonadherence were being a health care worker (or = 8.60; 95% ci: 2.09-35.41), being hiv-infected (or = 4.57; 95% ci: 1.2-17.5) and having had contact with a tb patient (or = 2.65; 95% ci: 1.15-6.12). conclusions: in order to improve adherence to tb chemoprophylaxis, new tb control program strategies are needed, especially for health care workers and hiv-infected patients.
Quimioprofilaxia na preven??o da tuberculose
Pineda, Norma I Soza;Pereira, Susan M.;Matos, Eliana Dias;Barreto, Mauricio L;
Jornal Brasileiro de Pneumologia , 2004, DOI: 10.1590/S1806-37132004000400015
Abstract: tuberculosis chemoprophylaxis is a therapeutic measure for the prevention of infection by mycobacterium tuberculosis or to avoid development of the disease in individuals already infected with it. isoniazid is the most commonly used therapy; however, the use of rifampicin and pyrazinamide has recently been introduced. the objectives of this study were to review the results of the principal studies evaluating the indications for chemoprophylaxis with isoniazid alone and in association with other drugs, its efficacy in the prevention of tuberculosis with respect to the different risk groups and the alternative regimens available. a systematic revision of the medical literature was carried out with particular emphasis on clinical trials and meta-analyses. official records were also consulted. those studies involving randomized clinical trials on the use of isoniazid, rifampicin or pyrazinamide in hiv-positive or negative patients were selected. isoniazid continues to be effective for the prevention of tuberculosis in populations of both hiv-negative and hiv-positive individuals. the standard dose of 5-15 mg/kg/day has shown similar protection over treatment periods ranging from six to twelve months. the risk of developing hepatitis was less than 1%; however monitoring during treatment is recommended in patients over 35 years of age and in users of alcohol. studies involving treatment regimens with other forms of medication were inconclusive and new studies would have to be performed to evaluate the efficacy of these regimens in populations at high risk of developing tuberculosis.
Mutations in rpoB and katG genes in Mycobacterium isolates from the Southeast of Mexico
Zenteno-Cuevas, R;Zenteno, JC;Cuellar, A;Cuevas, B;Sampieri, CL;Riviera, JE;Parissi, A;
Memórias do Instituto Oswaldo Cruz , 2009, DOI: 10.1590/S0074-02762009000300012
Abstract: the most frequent mutations associated with rifampin and isoniazid resistance in mycobacterium are the substitutions at codons 531 and 315 in the rpob and katg genes, respectively. hence, the aim of this study was to characterize these mutations in mycobacterium isolates from patients suspected to be infected with drug-resistant (dr) pulmonary tuberculosis (tb) in veracruz, mexico. drug susceptibility testing of 25 clinical isolates revealed that five were susceptible while 20 (80%) were dr (15% of the annual prevalence for veracruz). of the dr isolates, 15 (75%) were resistant to rifampin, 17 (85%) to isoniazid and 15 (75%) were resistant to both drugs (mdr). sequencing analysis performed in the isolates showed that 14 (93%) had mutations in the rpob gene; seven of these (47%) exhibited a mutation at 531 (s[l). ten (58%) of the 20 resistant isolates showed mutations in katg; nine (52%) of these 10 exhibited a mutation at 315 (s[t). in conclusion, the dr profile of the isolates suggests a significant number of different dr-tb strains with a low frequency of mutation at codons 531 and 315 in rpob and katg, respectively. this result leads us to consider different regions of the same genes, as well as other genes for further analysis, which is important if a genetic-based diagnosis of dr-tb is to be developed for this region.
Isoniazid-induced alopecia
Gupta K,Kumar V,Vishvkarma S,Shandily R
Lung India , 2011,
Abstract: Isoniazid is a safe and very effective antituberculosis drug. Antimitotic agents routinely cause alopecia. Drug-induced alopecia is usually reversible upon withdrawal of the drug. Isoniazid, thiacetazone and ethionamide are the antituberculosis drugs which have been associated with alopecia. Isoniazid-induced alopecia was observed in one case and confirmed by the finding that hair growth resumed when drug removed from the regimen.
Severe isoniazid related sideroblastic anemia
Rein Jan Piso,Kveti Kriz,Marie-Claire Desax
Hematology Reports , 2011, DOI: 10.4081/hr.2011.e2
Abstract: Isoniazid induced sideroblastic anemia is a rare event. We report case of a 45 year old Caucasian women with development of severe anaemia 4 month after introduction of Isoniazid as part of Tuberculosis treatment. While haemoglobin fell to 47 g/L and erythrocyte count to 1.5 G/L, reticulocytes were very low (reticulocyte production index of 0.48), but bone marrow aspirate showed an accelerated erythropoiesis with ringsideroblasts. Anaemia rapidly resolved after cessation of Isoniazid. We postulate an Isoniazid induced inhibition of the δ-Amino-levulinat-synthase resulting in marked depletion of heam synthesis.
The Professional Medical Journal , 2010,
Abstract: Objectives: To determine the frequency of hepatotoxicity with standard ATT. Study design: Descriptive. Setting: Department of Medicine, Combined Military Hospital Lahore. Period: Feb 2007 to April 2008. Materials & methods: 250 patients aged 18 years or greater having pulmonary TB were selected through non-probability convenience sampling technique. All patients were given four drugs for two monthsindoors, followed by two drugs for four months in outdoor. Symptoms suggestive of hepatotoxicity were enquired from the patients regularly. Serum bilirubin and ALT were measured on monthly basis and finally on completion of therapy. Hepatotoxicity was defined as a five fold rise in serum ALT. In patients developing hepatotoxicity, treatment was modified accordingly. Results: This study was done on 189 male and 61 female patients (total: 250). Hepatotoxicity developed in 13 (5.2%) patients, mostly during the initial phase of treatment (84.6% incidence during the first month). Risk factors included: age (4 out of 156 young patients and 9 out of 94 older patients; p: 0.016) and nutritional status (8 malnourished patients and 5 well nourished patients; p: 0.031). Hepatotoxicity was not related to the gender (9 males and 4 females; p: 0.585) or the results of baseline sputum smears (7 out of 102 smear positive cases and six out of 148 smear negative cases; p: 0.064). Conclusions: Hepatotoxicity with ATT is fairly common, especially in the elderly, malnourished patients and during the initial phase of treatment.
Isoniazid- and ethambutol-induced psychosis
Prasad R,Garg Rajiv,Verma Sanjay
Annals of Thoracic Medicine , 2008,
Abstract: Most cases of antituberculous agent-associated psychoses were caused by isoniazid (INH), with ethambutol (EMB)-induced psychosis being rare. The concomitant occurrence of INH- and EMB- induced psychosis and in a single individual is extremely uncommon. We report a case of 28-year-old male who developed psychotic symptoms on start of EMB initially and later on INH also. He was prescribed rifampicin, pyrazinamide, and ofloxacin and had no further psychotic symptoms.
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