[A case of tuberculous pleurisy associated with myoclonus and Quincke's edema due to isoniazid and isoniazid sodium methanesulfonate].

A case of tuberculous pleurisy associated with myoclonus and Quincke's edema due to isoniazid (INH) and isoniazid sodium methanesulfonate (IHMS) was reported. A 75-year-old man was admitted to our division because of chest discomfort and the left chest pain of one month's duration. A conventional chest roentgenogram revealed pleural effusion in the left thoracic cavity. The pleural specimen obtained from the left parietal pleura revealed caseating granuloma. Myoclonus suddenly appeared two months after the administration of antituberculous drugs for tuberculous pleurisy. Therefore, INH was discontinued. Three days later the patient's myoclonus disappeared and nine days later IHMS was newly administered. The patient abruptly developed myoclonus and Quincke's edema. IHMS was discontinued and 30 mg of prednisolone was simultaneously given. Two days later myoclonus disappeared and two days more later Quincke's edema was improved. The lymphocyte stimulation test using IHMS was positive. At that time, levels of serum vitamin B6 were within normal levels. These results suggest that myoclonus may result from epileptogenic action caused by INH or IHMS, and Quincke's edema may result from hypersensitive reaction associated with IHMS.