Hepatic dysfunction in children with tuberculosis on treatment with antituberculous therapy.

AIM

To determine the incidence and factors associated with drug induced hepatic dysfunction in children on anti-tuberculous treatment (ATT).

SETTING

Pediatric Tuberculosis Clinic at B.J. Wadia Children's Hospital, Mumbai.

MATERIAL AND METHODS

46 children with tuberculosis on ATT between April 2007 and February 2008 were included. Serum glutamic pyruvic transaminase (SGPT) level was measured at the beginning, after 15 days of starting ATT, at the end intensive phase and then if the patient developed symptoms of hepatic dysfunction. A value 3 times the normal value of the testing laboratory was considered to be significant for liver dysfunction. Liver dysfunction was analysed for association with factors like age, sex, weight, malnutrition, type of tuberculosis and severity of tuberculosis using SPSS Statistics software, Version 15.0.

RESULTS

Seven (15.2 %) out of 46 children developed drug induced hepatic dysfunction, of which 2 (28.6%) patients had 2 episodes of liver dysfunction while 5 (71.4%) had 1 episode of liver dysfunction. One (14.3%) developed symptom of hepatitis in the form of jaundice and hepatomegaly. All the patients developing liver dysfunction were in the intensive phase of treatment. The mean age of the children developing liver dysfunction was 4.0 ± 3.76 years. Liver dysfunction was associated with age younger than 3½ years (p = 0.025). Liver dysfunction was not associated with sex, weight, malnutrition, type of tuberculosis and severity of tuberculosis.

CONCLUSION

Regular monitoring of SGPT levels is recommended in all children on ATT below the age of 3 ½ years.