Acute liver injury and neutropenia due to antitubercular agents
10.3760/cma.j.issn.1008-5734.2019.05.017
- VernacularTitle:抗结核药物致急性肝损伤和中性粒细胞减少
- Author:
Xuemin YANG
1
;
Baorong SHEN
;
Pengyuan LIU
;
Kaining YANG
;
Qian ZHAO
;
Mengmeng WANG
Author Information
1. 保定市第二中心医院药剂科,河北省涿州市,050000
- Publication Type:Journal Article
- Keywords:
Isoniazid;
Rifampin;
Antitubercular agents;
Chemical and drug induced liver injury;
Neutropenia
- From:
Adverse Drug Reactions Journal
2019;21(5):389-390
- CountryChina
- Language:Chinese
-
Abstract:
A 30-year-old female patient received oral rifampicin 0.562 5 g (before breakfast) and isoniazid 0.4 g (after dinner) for pulmonary tuberculosis.There were no abnormalities in her blood routine and liver function indexes before medication.Three days after the medication,the patient developed fatigue,nausea,and vomiting.The next-day laboratory tests showed white blood cell count 1.1 × 109/L,neutrophil count 0.32 × 109/L,hemoglobin (Hb) 120 g/L,platelet count (PLT) 149 × 109/L,alanine aminotransferase (ALT) 368 U/L,aspartate aminotransferase (AST) 1 333 U/L,total bilirubin (TBil)19.7 μmol/L,and direct bilirubin (DBil) 6.6 μmol/L.Liver injury and neutropenia were diagnosed.Considering the reason from current medication,rifampicin and isoniazid were discontinued and liverprotective and symptomatic treatments were given.On day 4 of the withdrawal,the patient's symptoms improved and laboratory tests showed neutrophil count 1.50 × 109/L,ALT 163 U/L,AST 139 U/L,TBil 9.0 μmol/L,and DBil 3.7 μmol/L.On day 7 of the withdrawal,the patient's liver function improved (ALT 75 U/L,AST 33 U/L,TBil 6.4 μmol/L,and DBil 3.3 μmol/L) and her neutrophil count was 1.60 × 109/L.One week after discharge,the neutrophil count was 1.70 × 109/L;the levels of ALT,AST,TBil,and DBil were 30 U/L,34 U/L,10.0 μmol/L,and 4.2 μmol/L,respectively.
