Acute isoniazid overdose is a relatively uncommon but potentially life-threatening event. Isoniazid overdose should be suspected in any patient with repeated seizures, coma and metabolic acidosis of uncertain etiology. The effective antidote for acute isoniazid- induced neurotoxicity is known to be pyridoxine. We report a 4-month old boy who showed repeated seizures, coma, metabolic acidosis and hyperglycemia from an accidental isoniazid overdose(100 mg/kg). This boy was recovered completely by the pyridoxine treatment with a dose of equivalent to the amount of isoniazid ingested.
Acidosis ; Child ; Coma ; Humans ; Hyperglycemia ; Infant ; Isoniazid* ; Male ; Pyridoxine ; Seizures

One case of tuberculosis verrucosa cutis associated with inguinal lymphnode enlargement is presented. The patient, 24 years old male, has had palm-sized, dark-brown colored, indurated verrucous patch on left buttoek since 12 years old. Diagnosis was confirmed by characteristic clinical appearance, laboratory findings and histopathology. So he has been treated with I.N.A.H., P.A.S., streptomycin and pyridoxine. Remarkable effect was observed.
Child ; Diagnosis ; Humans ; Male ; Pyridoxine ; Streptomycin ; Tuberculosis* ; Young Adult

A case of lupus vulgaris who has the typical skin lesion on the patella region of the right knee was presented. The patient is 9 years old, the generally healthy male, and is no special finding of chest X-ray but tuberculin test was strong positive. The skin lesion started about 2 years ago as baby's palm sized erythematous patch with apple jelly nodule on the right knee joint region. Diagnosis was made by characteristic of clinical appearance and histulagial finding including other laboratory data. The treatment was done with INAH, PAS, streptomycin and pyridoxine for 3 months. Now,The skin lesion is almost healed and still continue treatment and observation go on.
Child ; Diagnosis ; Humans ; Knee Joint* ; Knee* ; Lupus Vulgaris* ; Male ; Patella* ; Pyridoxine ; Skin ; Streptomycin ; Thorax ; Tuberculin Test

PURPOSE: We analyzed retrospectively the effect of pyridoxine in the treatment of peripheral nerve related foot pain because we have seen favorable clinical results from it as a monotherapy. MATERIALS AND METHODS: We analyzed the clinical results of 200 cases of peripheral nerve related foot pain, treated with pyridoxine from March 2009 to February 2012. We devided them into three groups, peripheral neuritis, Morton's neuroma and posttraumatic neuralgia and recorded percentage of improvement of pain, compared to initial pain level at 2 weeks and 6 weeks. RESULTS: There were 127 peripheral neuritis cases, 22 Morton's neuroma and 51 posttraumatic neuralgia. At 2 weeks after treatment, 135 cases(67.5%) showed pain relief. At 6 weeks, 36 cases(21%) showed complete improvement of pain, 81 cases(47%) showed more than 50% of improvement, 22 cases(13%) showed less than 50% of improvement and 33 cases(19%) showed no improvement. There are 4 cases of gastrointestinal discomfort and 2 cases of aggravation of nervy pain. CONCLUSION: Pyridoxine was effective drug in the treatment of peripheral neuropathic pain in terms of pain relief, safety and cost effectiveness. So it can be an available first line drug before adding other drugs.
Cost-Benefit Analysis ; Foot ; Neuralgia ; Neuritis ; Neuroma ; Peripheral Nerves ; Pyridoxine ; Retrospective Studies

Isoniazid is one of the most commonly used antituberculosis drug. Acute into xication is characterized by repetitious convulsions, high anion gap metabolic a cidosis and coma. The basis of theraphy consists of parental pyridoxine admi nistration in a dose equivalent to that of isoniazid ingested. Here we present a case of seizure and metabolic acidosis due to only renal adjustment dosage of Isoniazid in an elderly woman.
Acid-Base Equilibrium ; Acidosis* ; Aged* ; Coma ; Female ; Humans ; Isoniazid* ; Parents ; Pyridoxine ; Seizures*

Isoniazid(Isonicotinic acid hydrazide) is an antimicrobial drug used since 1952 as a fast line agent for the prophylaxis and treatment of tuberculosis. Isoniazid is well known for problems in population having a high prevalence of isoniazid use for prophylaxis or treatment of tuberculosis. But intentional or accidental isoniazid overdose is uncommon. The ingestion of toxic amounts of isoniazid causes recurrent seizures, profound metabolic acidosis, coma and even death. In adults, toxicity can occur with the acute ingestion of as little as 1.5g of isoniazid. Doses larder than 30mg per kg often produce seizures. When ingested in amounts of 80-150mg per kg or more, isoniazid can be rapid fatal. 40-year-old woman having previous pulmonary tuberculosis ingested 7 gram of isoniazid(140mg/kg) to attempt suicide approximately 30 minutes prior to visit to our emergency medical center. She had recurrent generalized tonicclonic seizures and metabolic acidosis. We report one patient treated with pyridoxine, which was equivalent to the amount of isoniazid ingested and administered as a intravenous dose and oral dose.
Acidosis ; Adult ; Coma ; Eating ; Emergencies ; Female ; Humans ; Isoniazid* ; Prevalence ; Pyridoxine ; Seizures* ; Suicide ; Tuberculosis ; Tuberculosis, Pulmonary

Adolescent ; Adult ; Drug Combinations ; Humans ; Injections ; Male ; Pyridoxine ; administration & dosage ; pharmacokinetics ; Pyrrolidonecarboxylic Acid ; administration & dosage ; pharmacokinetics

PURPOSE: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. METHODS: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. RESULTS: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). CONCLUSION: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.
Acetylcysteine ; Antidotes ; Deferoxamine ; Emergencies ; Ethanol ; Flumazenil ; Glucagon ; Humans ; Hydroxocobalamin ; Immunoglobulins ; Information Centers ; Korea ; Methylene Blue ; Neurologic Manifestations ; Pyridoxine ; Suicide

The objective of this study is to determine the effectiveness of 4-month milk consumption in the prevention of osteoporosis in elderly women living in Asan. Subjects included 277 women age over 65 years were divided into control (n=111) and milk (n=166) groups. For those in the milk group, one cup (200ml) of partially lactose-digested low-fat milk was provided everyday for 4 months. Each subject was interviewed to assess food intake by 24-h recall method before and after milk supplementation. Prevalence of osteoporosis was determined by WHO criteria with calcaneus bone mineral density (BMD) measured by quantitative ultrasound (QUS) on left heel. After 4 months, the nutrient intake levels of control did not change while intakes of energy, protein, calcium, phosphorous, riboflavin, pyridoxin, niacin and folic acid were significantly increased in milk group. No significant changes were observed in anthropometric, and BMD in both control and milk groups. T-score of milk group, however, was significantly increased after 4 month milk consumption. Prevalence of osteoporosis was increased (27% to 32%) in control group while that of milk group was decreased (32% to 30%). When BMD and t-score changes after 4 months of milk consumption were compared between those with low baseline calcium intake and high calcium intake subjects in the milk group, BMD and t-score were significantly improved in the low baseline calcium intake group. We conclude that one cup a day milk consumption for a relatively short period of 4 months can prevent further bone loss and significantly improve intakes of both macro and micro-nutrients of elderly women.
Aged* ; Bone Density* ; Calcaneus ; Calcium* ; Chungcheongnam-do* ; Eating ; Female ; Folic Acid ; Heel ; Humans ; Milk* ; Niacin ; Osteoporosis ; Prevalence ; Pyridoxine ; Riboflavin ; Ultrasonography

Isoniazid (INH), a hydrazide of isonicotinic acid, has been used for more than 30 years for the treatment of tuberculosis and is one of the most effective anti-tuberculous agents so far. In spite of the widespread use of INH, very few accidental or suicidal poisonings have been reported, Acute INH intoxication is characterized by hyperpyrexia, respiratory distress, coma seizure, metabolic acisosis, hyperglycemia and acetonuria Especially metabolic acidosis is not corrected by alkali therapy in which usual dose of bicarbonate supply, and seizure attacks also has not controlled by common anti-epileptic drugs, so it needed a large quantity of intravenous pyridoxine and diazepam infusion. This report describes an adult who ingested large amount of INH with the intent of suicide and was presented with the fatal status epilepticus and severe metabolic acidosis.
Acidosis ; Adult ; Alkalies ; Coma ; Diazepam ; Humans ; Hyperglycemia ; Isoniazid* ; Isonicotinic Acids ; Ketosis ; Poisoning ; Pyridoxine ; Seizures ; Status Epilepticus ; Suicide ; Tuberculosis