[Hypersensitivity reactions to antituberculous therapy]

Hypersensitivity reactions to antituberculous drugs pose both a diagnostic and a therapeutic problem. This work aims to study the frequency of allergic reactions to antituberculous drugs, their clinical presentations and the diagnostic approach required.

This retrospective study covered the period from January 1990 to June 2008 at the Ibn Nafis Pulmonary Department of Abderrahmen Mami Hospital in Ariana. It dealt with 30 in-patients who experienced an allergic reaction to antituberculous drugs.

Cutaneous manifestations were the most frequent (80% of cases), predominantly urticarial. Thrombocytopenia was noted in two cases, anaphylactic shock in three cases, a systemic toxidermia in two cases and renal failure in one patient. Pyrazinamide was implicated in most cases (28%) when only one drug was considered to be responsible for the reaction. Interrupting either one drug or the whole treatment was necessary to define the cause of the reaction. The clinical evolution of hypersensitivity signs was favorable in all cases following definitive withdrawal of the responsible drug. Complete recovery from tuberculosis occurred in all cases.

Close monitoring of patients on antituberculous treatment is required to detect the onset of any allergic reaction and ensure an adequate compliance with treatment.