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Isoniazid-associated rhabdomyolysis
D L Blowey1, D Johnson, Z Verjee
1Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, University of Toronto, Ontario, Canada.
The American Journal of Emergency Medicine
|September 1, 1995
Summary
Acute isoniazid overdose in a teenager caused severe rhabdomyolysis and hepatitis. Prompt medical care led to a full recovery, highlighting the importance of considering these complications in isoniazid toxicity cases.
Area of Science:
- Toxicology
- Hepatology
- Neurology
Background:
- Isoniazid is a first-line antituberculosis medication.
- Acute overdose can lead to severe toxicity.
- Rhabdomyolysis and hepatitis are known, but less common, isoniazid toxicities.
Observation:
- A 17-year-old female presented after ingesting 10.8 g of isoniazid.
- Initial blood concentration of isoniazid was 1,230 mmol/L.
- No co-ingestion of other potential hepatotoxic or myotoxic substances was identified.
Findings:
- The patient developed rhabdomyolysis with a peak creatine phosphokinase of 88,000 U/L.
- Significant isoniazid-induced hepatitis was observed, with a peak aspartate aminotransferase of 1,980 U/L.
- Complete recovery occurred without lasting liver or renal damage.
Implications:
- Isoniazid overdose can cause severe rhabdomyolysis and hepatitis.
- Clinicians should consider these potential complications in acute isoniazid ingestions.
- Early recognition and management are crucial for favorable outcomes in isoniazid toxicity.