Philipose Jobin, Suchman Kelly I, Aronsky Danielle, Lee Tai-Ping
Gastroenterology and Hepatology, Staten Island University Hospital, Staten Island, USA.
Internal Medicine, Northwell Health, Manhasset, USA.
Cureus. 2022 Feb 21;14(2):e22452. doi: 10.7759/cureus.22452. eCollection 2022 Feb.
Isoniazid (INH) is widely used for latent despite the known risk of liver injury, with severe hepatitis occurring in up to 1% of patients. We report a patient who presented with two weeks of anorexia, nausea, and jaundice following six months of INH monotherapy for latent tuberculosis (TB). After other causes of liver injury were ruled out, she underwent a liver biopsy showing submassive necrosis, hepatocellular dropout, and lobular inflammation with no evidence of fibrosis. She was also found to have acute portal hypertension. She was diagnosed with drug-induced liver injury (DILI) and was treated with n-acetyl cysteine (NAC), ursodiol, and vitamin K. She recovered without the need for a liver transplant. This case supports the need for monitoring of liver tests in high-risk individuals on INH therapy to reduce the risk of hepatotoxicity.
异烟肼（INH）虽已知有肝损伤风险，但仍广泛用于潜伏性结核病的治疗，高达1%的患者会发生严重肝炎。我们报告了一名患者，在接受异烟肼单药治疗潜伏性结核病6个月后，出现了两周的厌食、恶心和黄疸症状。在排除其他肝损伤原因后，她接受了肝活检，结果显示为亚大块坏死、肝细胞脱落和小叶炎症，无纤维化迹象。她还被发现患有急性门静脉高压症。她被诊断为药物性肝损伤（DILI），并接受了N - 乙酰半胱氨酸（NAC）、熊去氧胆酸和维生素K的治疗。她康复了，无需进行肝移植。该病例支持对接受异烟肼治疗的高危个体进行肝功能监测，以降低肝毒性风险。
