272
Abstract Views
120
PDF Download
Case-Study

Hyperuricemia, use of antituberculosis drugs, and liver injury: case report

Vina Yuwantari University of Surabaya, Indonesia Correspondence vinarobijali@gmail.com
,
Nur Oktafiyani Mardi Waluyo Regional Public Hospital, Indonesia Correspondence nuroktafiyani@gmail.com
,
Nurmelinda Hadi Ningrum Mardi Waluyo Regional Public Hospital, Indonesia Correspondence nurmelindah@gmail.com
,
M. Hari Pristantiningtyas Mardi Waluyo Regional Public Hospital, Indonesia Correspondence maditoo@gmail.com
,
Herya Putra Dharma Mardi Waluyo Regional Public Hospital, Indonesia Correspondence heryaputra@gmail.com
,
Muhammad Muchlis Mardi Waluyo Regional Public Hospital, Indonesia Correspondence paklurah010670@gmail.com
,
Jainuri Erik Pratama Dr. Kariadi Central General Hospital, Indonesia Correspondence erik.rssa@gmail.com
,
Fauna Herawati University of Surabaya, Indonesia Correspondence fauna@staff.ubaya.ac.id
,
Adji Prayitno Setiadi University of Surabaya, Indonesia Correspondence adji¬_ps@staff.ubaya.ac.id
,
Marisca Evalina Gondokesumo Universitas Surabaya, Indonesia Correspondence marisca@staff.ubaya.ac.id
Pages 40-45
Browse this journal

Abstract

Anti-tuberculous drug can cause idiosyncratic drug-induced liver injury (DILI). Considering the benefit risk, there will discontinuation therapy and rechallenge after symptom resolve. In addition to anti-tuberculosis drugs, liver injury can occur in patients with hyperuricemia. We report a 60-year-old male patient who had just used the initiation phase of OAT for 20 days experiencing hepatotoxic side effects characterized by complaints of nausea and vomiting for one week. Liver function examination results were normal with AST 23 u/L and ALT 9 u/L. OAT administration was temporarily stopped and started gradually with 150 mg rifampicin, 150 mg isoniazid and 500 mg ethambutol. The second day after using OAT again, given the full dose of 300 mg rifampicin, 300 mg isoniazid and 1000 mg ethambutol. The patient's condition improved after this modification of therapy so that therapy with three anti-TB drugs was continued until he was discharged from the hospital.

There is no Figure or data content available for this article

References

  • Vos T, Lim SS, Abbafati C, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396(10258):1204-1222. doi:10.1016/S0140-6736(20)30925-9
  • Soeroto AY, Lestari BW, Santoso P, et al. Evaluation of Xpert MTB-RIF guided diagnosis and treatment of rifampicin-resistant tuberculosis in Indonesia: A retrospective cohort study. PLoS One. 2019;14(2):e0213017. doi:10.1371/journal.pone.0213017
  • Ramappa V, Aithal GP. Hepatotoxicity related to anti-tuberculosis drugs: Mechanisms and management. J Clin Exp Hepatol. 2013;3(1):37-49. doi:10.1016/j.jceh.2012.12.001
  • Cao J, Mi Y, Shi C, et al. First-line anti-tuberculosis drugs induce hepatotoxicity: A novel mechanism based on a urinary metabolomics platform. Biochem Biophys Res Commun. 2018;497(2):485-491. doi:10.1016/j.bbrc.2018.02.030
  • Pratiwi EP, Rohmawaty E, Kulsum ID. Efek samping obat anti tuberkulosis kategori I dan II pasien tuberkolosis paru dewasa di Rumah Sakit Hasan Sadikin. Indonesian Journal of Clinical Pharmacy. 2018;7(4):252. doi:10.15416/ijcp.2018.7.4.252
  • Li F, Lu J, Cheng J, et al. Human PXR modulates hepatotoxicity associated with rifampicin and isoniazid co-therapy. Nat Med. 2013;19(4):418-420. doi:10.1038/nm.3104
  • Wang P, Pradhan K, Zhong X bo, Ma X. Isoniazid metabolism and hepatotoxicity. Acta Pharm Sin B. 2016;6(5):384-392. doi:10.1016/j.apsb.2016.07.014
  • Huang L, He X, Peng W, et al. Hyperuricemia induces liver injury by upregulating HIF-1? and inhibiting arginine biosynthesis pathway in mouse liver and human L02 hepatocytes. Biochem Biophys Res Commun. 2022;617:55-61. doi:10.1016/j.bbrc.2022.05.096
  • Aminy RZ, Kholili U. Anti-tuberculosis drug-induced liver injury in patient with hepatitis B and cirrhosis: A case report. Annals of Medicine & Surgery. 2022;80. doi:10.1016/j.amsu.2022.104154
  • Yimer G, Gry M, Amogne W, et al. Evaluation of patterns of liver toxicity in patients on antiretroviral and anti-tuberculosis drugs: A prospective four arm observational study in ethiopian patients. PLoS One. 2014;9(4):e94271. doi:10.1371/journal.pone.0094271
  • Shravan Kumar P, Vidya R, Jageer M. Anti-tuberculosis treatment: induced hepatotoxicity-a case report. The Journal of the International Federation of Clinical Chemistry and Laboratory Medicine. 2020;31(3):242-247. Accessed December 21, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7545132/pdf/ejifcc-31-242.pdf
  • Son CG. A severe hepatotoxicity by antituberculosis drug, and its recovery in oriental hospital. Journal of Korean Medicine. 2016;37(2):119-124. doi:10.13048/jkm.16028
  • Niu H, Sanabria-Cabrera J, Alvarez-Alvarez I, et al. Prevention and management of idiosyncratic drug-induced liver injury: Systematic review and meta-analysis of randomised clinical trials. Pharmacol Res. 2021;164:105404. doi:10.1016/j.phrs.2020.105404
  • Abbara A, Chitty S, Roe JK, et al. Drug-induced liver injury from antituberculous treatment: a retrospective study from a large TB centre in the UK. BMC Infect Dis. 2017;17(1):231. doi:10.1186/s12879-017-2330-z
  • Soedarsono S, Riadi ARW. Tuberculosis Drug-Induced Liver Injury. Jurnal Respirasi. 2020;6(2):49. doi:10.20473/jr.v6-i.2.2020.49-54
  • Saha A, Shanthi F.X. M, Winston A. B, et al. Prevalence of Hepatotoxicity From Antituberculosis Therapy. J Prim Care Community Health. 2016;7(3):171-174. doi:10.1177/2150131916642431
  • Molla Y, Wubetu M, Dessie B. Anti-Tuberculosis drug induced hepatotoxicity and associated factors among tuberculosis patients at selected hospitals, Ethiopia. Hepat Med. 2021;Volume 13:1-8. doi:10.2147/HMER.S290542
  • Shen T, Liu Y, Shang J, et al. Incidence and etiology of drug-induced liver injury in Mainland China. Gastroenterology. 2019;156(8):2230-2241.e11. doi:10.1053/j.gastro.2019.02.002
  • Devarbhavi H, Singh R, Patil M, Sheth K, Adarsh CK, Balaraju G. Outcome and determinants of mortality in 269 patients with combination anti?tuberculosis drug?induced liver injury. J Gastroenterol Hepatol. 2013;28(1):161-167. doi:10.1111/j.1440-1746.2012.07279.x
  • Yew WW, Chang KC, Chan DP. Oxidative stress and First-Line antituberculosis Drug-Induced hepatotoxicity. Antimicrob Agents Chemother. 2018;62(8). doi:10.1128/AAC.02637-17
  • Ramappa V, Aithal GP. Hepatotoxicity related to Anti-tuberculosis drugs: Mechanisms and management. J Clin Exp Hepatol. 2013;3(1):37-49. doi:10.1016/j.jceh.2012.12.001
  • Chemotherapy and management of tuberculosis in the United Kingdom: recommendations 1998. Thorax. 1998;53(7):536-548. doi:10.1136/thx.53.7.536
  • Saukkonen JJ, Cohn DL, Jasmer RM, et al. An official ATS statement: Hepatotoxicity of antituberculosis therapy. Am J Respir Crit Care Med. 2006;174(8):935-952. doi:10.1164/rccm.200510-1666ST
  • Hoppe LE, Kettle R, Eisenhut M, Abubakar I. Tuberculosis-diagnosis, management, prevention, and control: summary of updated NICE guidance. BMJ. Published online January 13, 2016:h6747. doi:10.1136/bmj.h6747
  • Nagarajan S, Whitaker P. Management of adverse reactions to first-line tuberculosis antibiotics. Curr Opin Allergy Clin Immunol. 2018;18(4):333-341. doi:10.1097/ACI.0000000000000462
  • Hussain Z, Zhu J, Ma X. Metabolism and hepatotoxicity of pyrazinamide, an antituberculosis drug. Drug Metabolism and Disposition. 2021;49(8):679-682. doi:10.1124/dmd.121.000389
  • Rawat A, Chaturvedi S, Singh A, et al. Metabolomics approach discriminates toxicity index of pyrazinamide and its metabolic products, pyrazinoic acid and 5-hydroxy pyrazinoic acid. Hum Exp Toxicol. 2018;37(4):373-389. doi:10.1177/0960327117705426
  • Shih TY, Pai CY, Yang P, Chang WL, Wang NC, Hu OYP. A novel mechanism underlies the hepatotoxicity of pyrazinamide. Antimicrob Agents Chemother. 2013;57(4):1685-1690. doi:10.1128/AAC.01866-12
There is no Supplemental content for this article.

How to Cite This

Yuwantari, V., Oktafiyani, N., Ningrum, N. H., Pristantiningtyas, M. H., Dharma, H. P., Muchlis, M., … Gondokesumo, M. E. (2023). Hyperuricemia, use of antituberculosis drugs, and liver injury: case report. Jurnal Teknologi Laboratorium, 12(1), 40–45. https://doi.org/10.29238/teknolabjournal.v12i1.445

Article Metrics

Download Statistics

Downloads

Download data is not yet available.

Other Statistics

Verify authenticity via CrossMark

Copyright and Permissions

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Publishing your paper with Jurnal Teknologi Laboratorium (JTL) means that the author or authors retain the copyright in the paper. JTL granted an exclusive reuse license by the author(s), but the author(s) are able to put the paper onto a website, distribute it to colleagues, give it to students, use it in your thesis etc, even commercially. The author(s) can reuse the figures and tables and other information contained in their paper published by JTL in future papers or work without having to ask anyone for permission, provided that the figures, tables or other information that is included in the new paper or work properly references the published paper as the source of the figures, tables or other information, and the new paper or work is not direct at private monetary gain or commercial advantage.

JTL journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. This journal is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. This license lets others remix, transform, and build upon the material for any purpose, even commercially.

JTL journal Open Access articles are distributed under this Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA). Articles can be read and shared for All purposes under the following conditions:

  • BY: You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • SA:  If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.

Data Availability

All data generated during this study are included in this published article [and its supplementary information files].