- P-ISSN 1010-0695
- E-ISSN 2288-3339
Objectives: To demonstrate a clinical course and feature of a female patient with a severe liver injury (DILI) during antituberculosis treatment for her intestinal tuberculosis, whom traditional Korean medicine completely recovered. Methods: A female patient with diagnosed as DILI by antituberculosis drugs had been treated with herbal drugs; and then the clinical outcome and biochemical parameters had been monitored. Result: A 45-year old female had taken antituberculosis drugs for about 2 months, and complained severe abdominal discomfort and dyspepsia. The RUCAM score was 10, which met the criteria for DILI (AST 584 IU/L, ALT 1212 IU/L, ALP 100 IU/L, and GGT 161 IU/L, total bilirubin 0.9 mg/dL). She had been treated with herbal drugs and acupuncture as inpatient and outpatient, and then her symptoms had been completely recovered with normalization of hepatic enzymes. Conclusion: This report provides a clinical characteristic for a severe hepatotoxicity induced by antituberculosis drugs, and showed an example of TKM-based application.
1. Pandit A, Sachdeva T, Bafna P. Drug-Induced Hepatotoxicity: A Review. J Appl Pharma. Science. 2012;2(5):233-43.
2. Larson AM, Polson J, Fontana RJ, Davern TJ, Lalani E, Hynan LS, et al. Acetaminophen-induced acute liver failure: results of a United States multicenter, prospective study. Hepatology. 2005;42(6):1364-72.
3. Suk KT, Kim DJ. Drug-induced liver injury:present and future. Clin Mol Hepatol. 2012;18(3):249-57.
4. Meier Y, Cavallaro M, Roos M, Pauli-Magnus C, Folkers G, Meier PJ, et al. Incidence of drug-induced liver injury in medical inpatients. Eur J Clin Pharmacol. 2005;61(2):135-43.
5. Ghabril M, Chalasani N, Björnsson E. Drug -induced liver injury: a clinical update. Curr Opin Gastroenterol. 2010;26(3):222-6.
6. David S, Hamilton JP. Drug-induced Liver Injury. US Gastroenterol Hepatol Rev. 2010;6:73-80.
7. World Health Organization. Global Tuberculosis Report 2013. Geneva: World Health Organization, 2013.
8. Senousy BE, Belal SI, Draganov PV. Hepatotoxic effects of therapies for tuberculosis. Nat Rev Gastroenterol Hepatol. 2010;7(10):543-56.
9. Sun Q, Zhang Q, Gu J, Sun WW, Wang P, Bai C, et al. Prevalence, risk factors, management, and treatment outcomes of first-line antituberculous drug-induced liver injury: a prospective cohort study. Pharmacoepidemiol Drug Saf. 2016. doi:10.1002/pds.3988. Ahead of print.
10. Suk KT, Kim DJ, Kim CH, Park SH, Yoon JH, Kim YS, et al. A prospective nationwide study of drug-induced liver injury in Korea. Am J Gastroenterol. 2012;107(9):1380-7.
11. Seo JC, Jeon WJ, Park SS, Kim SH, Lee KM, Chae HB, et al. Clinical experience of 48 acute toxic hepatitis patients. Korean J Hepatol. 2006;12(1):74-81.
12. Chun WJ, Yoon BG, Kim NI, Lee G, Yang CH, Lee CW, et al. A clinical study of patients with acute liver injury caused by herbal medication in Gyeongju area. Korean J Med. 2002;63(2):141-50.
13. U.S. National Library of Medicine. Available at:URL:https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682401.html#side-effec. Accessed May 10, 2016
14. Drugs.com. Available at: URL:http://www.drugs. com/sfx/ethambutol-side-effects.html#refs. Accessed May 01, 2016
15. Drugs.com. Available at: URL:http://www.drugs. com/sfx/rifampin-side-effects.html. Accessed May 01, 2016
16. Lee JY. Diagnosis and Treatment of Extrapulmonary Tuberculosis. Tuberc Respir Dis. 2015;78(2):47-55.
17. Park JS. Issues Related to the Updated 2014Korean Guidelines for Tuberculosis. Tuberc Respir Dis. 2016;79(1):1-4.
18. Lucena MI, García-Cortés M, Cueto R, Lopez -Duran J, Andrade RJ. Assessment of drug-induced liver injury in clinical practice. Fundam Clin Pharmacol. 2008;22(2):141-58.
19. Au JS, Navarro VJ, Rossi S. Review article:Drug-induced liver injury its pathophysiology and evolving diagnostic tools. Aliment Pharmacol Ther. 2011;34(1):11-20.
20. Saha A, Shanthi FXM, Winston AB, Das S, Kumar A, Michael JS, et al. Prevalence of Hepatotoxicity From Antituberculosis Therapy:A Five-Year Experience From South India. J Prim Care Community Health. 2016;pii: 2150131916642431(Epub ahead of print).
21. Isa SE, Ebonyi AO, Shehu NY, Idoko P, Anejo-Okopi JA, Simji G, et al. Antituberculosis drugs and hepatotoxicity among hospitalized patients in Jos, Nigeria. Int J Mycobacteriol. 2016;5(1):21-6.
22. Wondwossen Abera, Waqtola Cheneke, Gemeda Abebe. Incidence of antituberculosis-drug-induced hepatotoxicity and associated risk factors among tuberculosis patients in Dawro Zone, South Ethiopia: A cohort study. Int J Mycobacteriol. 2016;5(1):14-20.
23. Center for Disease Control Latent Tuberculosis Infection: A Guide for Primary Health Care Providers. cdc.gov. Retrieved 25 March 2016.
24. Gaude GS, Chaudhury A, Hattiholi J. Drug -induced hepatitis and the risk factors for liver injury in pulmonary tuberculosis patients. J Family Med Prim Care. 2015;4(2):238-43.
25. Madariaga MG. Drug-related hepatotoxicity. N Engl J Med. 2006;354(20):2191-3.
26. Chalasani N, Fontana RJ, Bonkovsky HL, Watkins PB, Davern T, Serrano J, et al. Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States. Gastroenterology. 2008;135(6):1924-34.
27. Shigeto E. Committee for Treatment Japanese Society for Tuberculosis. Survey of anti-tuberculosis drug-induced severe liver injury in Japan. Kekkaku. 2007;82(5):467-73.
28. Lee CM, Lee SS, Lee JM, Cho HC, Kim WS, Kim HJ, et al. Early monitoring for detection of antituberculous drug-induced hepatotoxicity. Korean J Intern Med. 2016;31(1):65-72.
29. Ramappa V, Aithal GP. Hepatotoxicity Related to Anti-tuberculosis Drugs: Mechanisms and Management. J Clin Exp Hepatol. 2013;3(1):37-49.
30. Chalasani N, Fontana RJ, Bonkovsky HL, Watkins PB, Davern T, Serrano J, et al. Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States. Gastroenterology. 2008;135(6):1924-34.
31. Andrade RJ, Lucena MI, Kaplowitz N, García -Muņoz B, Borraz Y, Pachkoria K, et al. Outcome of acute idiosyncratic drug-induced liver injury: Long-term follow-up in a hepatotoxicity registry. Hepatology. 2006;44(6):1581-8.
32. Suk KT, Kim DJ, Kim CH, Park SH, Yoon JH, Kim YS, et al. A prospective nationwide study of drug-induced liver injury in Korea. Am J Gastroenterol. 2012;107(9):1380-7.
33. Park HM, Jang IS, Lee SD. Hepatotoxic Events Associated with Herbal Medicinal Products, Folk Remedies and Food Supplements in Korea. J Korean Oriental Med. 2005;26(2):152-65.