Isoniazid-Induced Acute Liver Failure Requiring Liver Transplantation

Area of Science:

• Infectious Diseases
• Hepatology
• Pharmacology

Background:

• Tuberculosis (TB) remains a significant global health challenge, with latent infections posing a risk of progression to active disease.
• Isoniazid is a cornerstone medication for both latent and active TB treatment.
• Drug-induced liver injury is a known, albeit infrequent, complication of isoniazid therapy.

Observation:

• A 60-year-old woman with latent TB infection was initiated on isoniazid treatment.
• After five months of therapy, the patient developed acute liver failure.
• The liver failure was directly attributed to isoniazid, necessitating a liver transplant.

Findings:

• This case illustrates a severe adverse reaction to isoniazid, a widely prescribed anti-TB medication.
• The patient experienced drug-induced liver failure, a critical complication requiring intensive medical intervention.
• Successful liver transplantation led to a favorable clinical outcome for the patient.

Implications:

• Highlights the critical need for vigilant monitoring of liver function in patients receiving isoniazid.
• Emphasizes the importance of developing and implementing robust follow-up strategies for TB treatment.
• Underscores the potential for severe hepatotoxicity from isoniazid, even in latent TB cases.