Abstract
The incidence of INH-associated liver injury was evaluated in 239 children aged between 9 and 14 years, who were receiving 300 mg INH/day for tuberculosis prophylaxis. Serum SGOT and SGPT levels were determined before INH administration and at 4-weekly intervals thereafter. Levels of both enzymes were raised during the first 3 months of treatment in 18 (7.5%) children, while in 23 (9.6%) children either SGOT or SGPT exceeded normal levels (SGOT greater than 40 units, SGPT greater than 30 units). Only 2 (0.8%) children showed SGOT and SGPT values above 100 units and in them treatment with INH had to be discontinued. In all other children transaminases returned to normal during uninterrupted INH administration. It was noted also that transaminase values in children who did not exhibit a rise above normal, still had significantly higher levels during treatment compared with before. The findings of this study suggest that liver injury in children receiving INH for prophylaxis occurs more often than it had hitherto been believed but that it is usually mild and transient.
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- Bailey W. C., Taylor S. L., Dascomb H. E., Greenberg H. B., Ziskind M. M. Disturbed hepatic function during isoniazid chemoprophylaxis. Monitoring the hepatic function of 427 hospital employees receiving isoniazid chemoprophylaxis for tuberculosis. Am Rev Respir Dis. 1973 Apr;107(4):523–529. doi: 10.1164/arrd.1973.107.4.523. [DOI] [PubMed] [Google Scholar]
- Beaudry P. H., Brickman H. F., Wise M. B., MacDougall D. Liver enzyme disturbances during isoniazid chemoprophylaxis in children. Am Rev Respir Dis. 1974 Nov;110(5):581–584. doi: 10.1164/arrd.1974.110.5.581. [DOI] [PubMed] [Google Scholar]
- Black M., Mitchell J. R., Zimmerman H. J., Ishak K. G., Epler G. R. Isoniazid-associated hepatitis in 114 patients. Gastroenterology. 1975 Aug;69(2):289–302. [PubMed] [Google Scholar]
- Byrd C. B., Nelson R., Elliott R. C. Isoniazid toxicity. A prospective study in secondary chemoprophylaxis. JAMA. 1972 Jun 12;220(11):1471–1473. doi: 10.1001/jama.220.11.1471. [DOI] [PubMed] [Google Scholar]
- Garibaldi R. A., Drusin R. E., Ferebee S. H., Gregg M. B. Isoniazid-associated hepatitis. Report of an outbreak. Am Rev Respir Dis. 1972 Sep;106(3):357–365. doi: 10.1164/arrd.1972.106.3.357. [DOI] [PubMed] [Google Scholar]
- Litt I. F., Cohen M. I., McNamara H. Isoniazid hepatitis in adolescents. J Pediatr. 1976 Jul;89(1):133–135. doi: 10.1016/s0022-3476(76)80949-3. [DOI] [PubMed] [Google Scholar]
- Martin C. E., Arthaud J. B. Hepatitis after isoniazid administration. N Engl J Med. 1970 Feb 19;282(8):433–434. doi: 10.1056/NEJM197002192820808. [DOI] [PubMed] [Google Scholar]
- Mitchell J. R., Long M. W., Thorgeirsson U. P., Jollow D. J. Acetylation rates and monthly liver function tests during one year of isoniazid preventive therapy. Chest. 1975 Aug;68(2):181–190. doi: 10.1378/chest.68.2.181. [DOI] [PubMed] [Google Scholar]
- Mitchell J. R., Zimmerman H. J., Ishak K. G., Thorgeirsson U. P., Timbrell J. A., Snodgrass W. R., Nelson S. D. Isoniazid liver injury: clinical spectrum, pathology, and probable pathogenesis. Ann Intern Med. 1976 Feb;84(2):181–192. doi: 10.7326/0003-4819-84-2-181. [DOI] [PubMed] [Google Scholar]
- Moss J. D., Lewis J. E., Knauer C. M. Isoniazid-associated hepatitis. A study of five cases. Am Rev Respir Dis. 1972 Dec;106(6):849–856. doi: 10.1164/arrd.1972.106.6.849. [DOI] [PubMed] [Google Scholar]
- REITMAN S., FRANKEL S. A colorimetric method for the determination of serum glutamic oxalacetic and glutamic pyruvic transaminases. Am J Clin Pathol. 1957 Jul;28(1):56–63. doi: 10.1093/ajcp/28.1.56. [DOI] [PubMed] [Google Scholar]
- Rudoy R., Stuemky J., Poley J. R. Isoniazid administration and liver injury. Am J Dis Child. 1973 May;125(5):733–736. doi: 10.1001/archpedi.1973.04160050077016. [DOI] [PubMed] [Google Scholar]
- Scharer L., Smith J. P. Serum transaminase elevations and other hepatic abnormalities in patients receiving isoniazid. Ann Intern Med. 1969 Dec;71(6):1113–1120. doi: 10.7326/0003-4819-71-6-1113. [DOI] [PubMed] [Google Scholar]
- Vanderhoof J. A., Ament M. E. Fatal hepatic necrosis due to isoniazid chemoprophylaxis in a 15-year-old girl. J Pediatr. 1976 May;88(5):867–868. doi: 10.1016/s0022-3476(76)81134-1. [DOI] [PubMed] [Google Scholar]