Anti-Tuberculosis Treatment: Induced Hepatotoxicity - A Case Report

Tuberculosis is a potentially communicable disease that can infect any organ in the body such as bones, kidney, intestine but primarily involves lung parenchyma (Pulmonary tuberculosis). The prevalence of TB is 256 per 100,000 population in India. Hepatotoxicity, gastrointestinal and neurological disorders were some the Adverse Drug Reactions (ADR's) reported that significantly increases the mortality rate which leads to decreased efficacy of the treatment. Hepatotoxicity is the most commonly reported ADR in patients treated with anti-tubercular drugs such as isoniazid, rifampicin and pyrazinamide. Clinical manifestations of hepatotoxicity include abdominal pain, nausea, vomiting, and jaundice. We report the case of a 19-year-old female with complaints of yellowish discoloration of sclera for 45 days associated with vomitings for one week. She had a past medical history of tuberculosis for which she was advised with DOT (Direct Observation Therapy) regimen. A diagnosis of Anti-Tuberculosis Treatment (ATT) - induced hepatotoxicity was made based on the clinical examination and laboratory investigations which was successfully managed by providing supportive care and symptomatic treatment.