A Case of Prothionamide Induced Hepatitis on Patient with Multi-Drug Resistant Pulmonary Tuberculosis.

Park, Jun Beom; Park, Byung Hoon; Son, Ji Young; Jung, Ji Ye; Kim, Eun Young; Lim, Ju Eun; Lee, Sang Hoon; Lee, Sang Kook; Kim, Song Yee; Jung, Wonjai; Lim, Seungtaek; Lee, Kyung Jong; Kang, Young Ae; Kim, Young Sam; Kim, Se Kyu; Chang, Joon; Choi, Junjeong; Park, Moo Suk

doi:2011.70.3.251

Tuberc Respir Dis > Volume 70(3); 2011 > Article

Case Report

Tuberculosis and Respiratory Diseases 2011;70(3):251-256.
DOI: https://doi.org/10.4046/trd.2011.70.3.251 Published online March 1, 2011.

A Case of Prothionamide Induced Hepatitis on Patient with Multi-Drug Resistant Pulmonary Tuberculosis.

Jun Beom Park, Byung Hoon Park, Ji Young Son, Ji Ye Jung, Eun Young Kim, Ju Eun Lim, Sang Hoon Lee, Sang Kook Lee, Song Yee Kim, Wonjai Jung, Seungtaek Lim, Kyung Jong Lee, Young Ae Kang, Young Sam Kim, Se Kyu Kim, Joon Chang, Junjeong Choi, Moo Suk Park

¹Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. pms70@yuhs.ac
²The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.
³Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

The prevalence of multi-drug resistant tuberculosis (MDR-TB), which is resistant to isoniazid and rifampin, has been increasing in Korea. And the side effects of 2nd line anti-tuberculosis medications, including drug-induced hepatitis, are well known. Although prothionamide (PTH) is one of the most useful anti-TB medications and although TB medication-induced acute hepatitis is a severe complication, there are only a few published case reports about prothionamide induced hepatitis. In this case report, a 22 year old male was diagnosed with pulmonary MDR-TB and was administered 2nd line anti-TB mediations, including PTH. Afterwards, he had a spiking fever and his liver enzymes were more than 5 times greater than the upper limit of the normal range. He was then diagnosed with drug-induced hepatitis by liver biopsy. His symptoms and liver enzyme elevation were improved after stopping PTH. Accordingly, we report this case of an association between PTH and acute hepatitis.

Key Words: Tuberculosis, Multidrug-Resistant, Hepatitis, Prothionamide