October - LRS Institute of Tuberculosis & Respiratory Diseases

HEPATIC TOXICITY DUE TO ISONIAZID
193
of its high therapeutic efficiency and good
acceptability by the patients (Goodman and
Gillman 1970). Although isoniazid had been
implicated as a possible hepatotoxic agent
in a small number of cases (Cohen et al
1961; Davies and Glowinski 1961; Gellis and
Murphy 1955; Gillis and Texler 1960;
Haber and Osborne 1959; Merrit and
Fatter 1959; Randolph and Joseph 1953), the
patients who developed hapatitis were also
taking other drugs. Only in 1969, Scharer and
Smith showed conclusively that isoniazid alone
is also capable of inducing hepatocellular
injury.
There is a close relationship between
alcoholism and isoniazid-induced hepatitis
(Kopanoff et al 1978), but there was no
history of alcohol intake in our patient.
Accelerated recurrence of severe hepatitis
and jaundice as reported by Meddrey et al
1973, was also observed in our patient who
developed recurrence of jaundice within 72
hours after addition of isoniazid to the other
drugs which he was already taking. Nondevelopment
of jaundice with other drugs,
namely, rifampicin, ethambutol and
pyrazinamide and appearance of jaundice
when isoniazid was added were sufficient to
establish isoniazid as the hepatotoxic drug in
our patient.
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Davies, D. and Glowinski, J. J.: Jaundice due to isoniazid.
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Gellis, S.N. and Murphy, R.V. : Hepatitis following
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