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Isoniazid-induced pure red cell aplasia
Subraya Krishna Holla1, Basavaprabhu Achappa1, Pavan Manibettu Raguram1
1Department of Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, Karnataka, India.
BMJ Case Reports
|October 10, 2018
Summary
Pure red cell aplasia (PRCA) is a rare side effect of isoniazid treatment for tuberculosis. Promptly stopping isoniazid led to the recovery of severe anemia in a patient, highlighting its importance in differential diagnosis.
Area of Science:
- Hematology
- Pharmacology
- Infectious Diseases
Background:
- Isoniazid is a primary drug for treating tuberculosis.
- Pure red cell aplasia (PRCA) is a rare but serious adverse effect associated with certain medications.
- Anemia is a common symptom in patients with active tuberculosis.
Observation:
- A 28-year-old male patient presented with severe anemia.
- The patient was undergoing antitubercular therapy, including isoniazid, for pulmonary tuberculosis.
- The severe anemia was diagnosed as PRCA.
Findings:
- Discontinuation of isoniazid therapy resulted in a rapid and complete recovery from severe anemia.
- The case demonstrates a direct causal link between isoniazid use and the development of PRCA.
- Erythropoiesis-suppressing effects of isoniazid are implicated in the pathogenesis of PRCA.
Implications:
- PRCA should be considered in the differential diagnosis of unexplained anemia in patients receiving isoniazid.
- Clinicians should monitor for hematological side effects during isoniazid therapy.
- Early recognition and management of isoniazid-induced PRCA can prevent severe complications and ensure treatment adherence.
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