Related Experiment Video

Updated: May 20, 2026

Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
09:44

Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen

Published on: November 27, 2019

[Fulminant hepatic failure due to tuberculostatic drugs: case report]

Ivone Malla1, Martín Fauda, Enrique Casanueva

  • 1Hepatología y trasplante hepático pediátrico, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina. imalla@cas.austral.edu.ar

Archivos Argentinos De Pediatria
|July 5, 2012
PubMed

Insights

Isoniazid-induced liver injury is a rare side effect of tuberculosis treatment. A 10-year-old required a liver transplant due to acute liver failure from this drug combination.

Area of Science:

  • Hepatology
  • Pharmacology
  • Pediatric Medicine

Background:

  • Tuberculosis treatment commonly involves a combination of drugs, including isoniazid, rifampin, and pyrazinamide.
  • Drug-induced liver injury (DILI) is a known, albeit rare, complication of antitubercular therapy.
  • Hepatotoxicity associated with isoniazid, particularly when combined with rifampin, necessitates careful monitoring in pediatric patients.

Observation:

  • A 10-year-old patient developed acute liver failure after 40 days of treatment for tuberculosis.
  • The patient was receiving a standard regimen of isoniazid, rifampin, and pyrazinamide.
  • This led to the critical need for an orthotropic liver transplant.

Findings:

  • The case highlights a severe instance of drug-induced hepatotoxicity from a common tuberculosis medication regimen.
  • Pediatric orthotropic liver transplant is rarely associated with drug hepatotoxicity, accounting for 14% of such cases.
  • This specific case underscores the potential for isoniazid and rifampin combination to cause acute liver failure.

Implications:

  • Early recognition and monitoring for hepatotoxicity are crucial in pediatric patients undergoing tuberculosis treatment.
  • This case emphasizes the importance of considering drug-induced liver injury in the differential diagnosis of acute liver failure in children.
  • Further research into risk factors and preventative strategies for antitubercular drug-induced hepatotoxicity is warranted.

Related Concept Videos

Pulmonary Tuberculosis V01:28

Pulmonary Tuberculosis V

Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
Pulmonary Tuberculosis I01:29

Pulmonary Tuberculosis I

Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug01:14

Effect of Hepatic Disease on Pharmacokinetics: Active Drug, Metabolite and Fraction of Metabolized Drug

In pharmacotherapy, monitoring drug concentrations is paramount, especially for drugs whose therapeutic effects hinge on both the active compound and its metabolite. Hepatic impairment profoundly influences drug potency by altering liver function. If the drug is more potent than its metabolite, impaired liver function amplifies drug activity due to elevated drug concentration levels. Conversely, if the metabolite holds greater potency, diminished liver function diminishes drug activity by...
Drug toxicity: Idiosyncratic Reactions01:16

Drug toxicity: Idiosyncratic Reactions

Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...