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Isoniazid-associated hepatitis--serum enzyme determinations and histologic features
The Western Journal of Medicine
|May 1, 1975
Summary
Isoniazid preventive therapy for tuberculosis can cause elevated liver enzymes (SGOT) in adults and children. While often mild and self-limiting in adults, symptomatic cases may experience prolonged SGOT elevation.
Area of Science:
- Hepatology
- Pharmacology
- Infectious Diseases
Background:
- Isoniazid (INH) is a key drug for tuberculosis prophylaxis.
- Monitoring liver function during INH treatment is crucial due to potential hepatotoxicity.
Purpose of the Study:
- To evaluate the incidence and characteristics of liver enzyme elevations during isoniazid prophylaxis.
- To assess the clinical and biochemical outcomes of isoniazid-induced SGOT elevation.
Main Methods:
- Prospective study of 208 patients receiving isoniazid for tuberculosis prophylaxis.
- Monitoring of serum glutamic oxaloacetic transaminase (SGOT) levels.
- Clinical assessment for symptoms and liver biopsy in select cases.
Main Results:
- Elevated SGOT levels observed in 20% of adults and 2 of 33 children.
- 30% of adults developed nonspecific symptoms, with 11% concurrent with SGOT elevation.
- Mild SGOT elevations in asymptomatic adults were self-limiting; symptomatic cases showed prolonged elevation.
Conclusions:
- Isoniazid prophylaxis can lead to asymptomatic or symptomatic SGOT elevations.
- Hepatotoxicity from isoniazid appears to be dose-dependent and reversible.
- Liver biopsy findings suggest an inflammatory response in early-stage isoniazid-induced liver injury.