Harnam Hotchandani, Khemchand N Moorani, Yasmeen Kazi.
Anti-tuberculosis therapy induced hepatotoxicity in children.
Pak Paed J Jan ;37(2):117-22.

Objective: To determine the frequency of drug induced hepatotoxicity in children on anti-tuberculous therapy (ATT). Study Design: Case series study Place and Duration: National Institute of Child Health, Karachi from September 2010-Feb 2011. Methodology: Seventy nine children aged 1-14 years of either gender who were on standard ATT for various types of tuberculosis (TB) and developed anti-TB drug-induced hepatotoxicity (ATDIH) were studied. Patients with viral hepatitis, chronic liver disease were excluded. The data including age, gender, site of tuberculosis, types of ATT, duration of therapy and hepatotoxicity were collected and analyzed on SPSS version 15 using descriptive statistics. Results: Among 79 patients, 44 (55.7%) were boys and 35 (44.3%) girls. Mean age was 7 ± 3.2 years and mean duration of therapy was 3.8 ± 1.1 months. Sixty five (82.3%) had pulmonary TB, 10 (12.7%) abdominal TB and 04 (5.1%) had TB meningitis. Overall 11 patients (13.92%) developed ATDIH and all developed with in intensive phase of ATT. ATDIH was more common in boys (9, 81.8%) than girls (p=0.060).ATDIH was observed in majority (72%) of cases with pulmonary TB. Isoniazid was the most common drug responsible for ATDIH found in 06 (54.5%) followed by rifampicin (18.2%) and combined drug toxicity {(27.3%) p <0.05}. Conclusion: We observed ATDIH in 14% of cases in the intensive phase of treatment. We recommend monitoring of serum alanine transaminase levels for ATDIH to prevent associated morbidity, mortality and treatment failure.

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