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Huh JY, Lee D, Ahn J, Shim JH, Lim YS, Park GC, Song GW, Kim KH, Jung DH, Moon DB, Hwang S, Lee SG, Lee SW, Song JW, Oh YM, Shim TS, Jo KW. Impact of emergency adult living donor liver transplantation on the survival of patients with antituberculosis therapy-induced acute liver failure. Liver Transpl 2017; 23:845-846. [PMID: 28006868 DOI: 10.1002/lt.24697] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 12/02/2016] [Indexed: 01/13/2023]
Affiliation(s)
- Jin-Young Huh
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Danbi Lee
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jihyun Ahn
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Ju Hyun Shim
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Young-Suk Lim
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Gil-Chun Park
- Division of Liver Transplantation and Hepato-Biliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Gi-Won Song
- Division of Liver Transplantation and Hepato-Biliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Ki-Hun Kim
- Division of Liver Transplantation and Hepato-Biliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Dong-Hwan Jung
- Division of Liver Transplantation and Hepato-Biliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Deok-Bog Moon
- Division of Liver Transplantation and Hepato-Biliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Shin Hwang
- Division of Liver Transplantation and Hepato-Biliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Sung Gyu Lee
- Division of Liver Transplantation and Hepato-Biliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Sei Won Lee
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jin-Woo Song
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Yeon-Mok Oh
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Tae Sun Shim
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Kyung-Wook Jo
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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Bartoletti M, Martelli G, Tedeschi S, Morelli M, Bertuzzo V, Tadolini M, Pianta P, Cristini F, Giannella M, Lewis RE, Pinna AD, Viale P. Liver transplantation is associated with good clinical outcome in patients with active tuberculosis and acute liver failure due to anti-tubercular treatment. Transpl Infect Dis 2017; 19. [DOI: 10.1111/tid.12658] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/13/2016] [Accepted: 09/25/2016] [Indexed: 01/09/2023]
Affiliation(s)
- Michele Bartoletti
- Infectious Diseases Unit; Department of Medical and Surgical Sciences; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - Giulia Martelli
- Infectious Diseases Unit; Department of Medical and Surgical Sciences; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - Sara Tedeschi
- Infectious Diseases Unit; Department of Medical and Surgical Sciences; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - Mariacristina Morelli
- Internal Medicine Unit for the Treatment of Severe Organ Failure; Department of Medical and Surgical Sciences; Sant'Orsola Hospital; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - Valentine Bertuzzo
- Liver and Multi-Organ Transplant Unit; Department of Medical and Surgical Sciences; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - Marina Tadolini
- Infectious Diseases Unit; Department of Medical and Surgical Sciences; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - Paolo Pianta
- Internal Medicine Unit for the Treatment of Severe Organ Failure; Department of Medical and Surgical Sciences; Sant'Orsola Hospital; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - Francesco Cristini
- Infectious Diseases Unit; Department of Medical and Surgical Sciences; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - Maddalena Giannella
- Infectious Diseases Unit; Department of Medical and Surgical Sciences; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - Russell E. Lewis
- Infectious Diseases Unit; Department of Medical and Surgical Sciences; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - Antonio D. Pinna
- Liver and Multi-Organ Transplant Unit; Department of Medical and Surgical Sciences; Alma Mater Studiorum University of Bologna; Bologna Italy
| | - Pierluigi Viale
- Infectious Diseases Unit; Department of Medical and Surgical Sciences; Alma Mater Studiorum University of Bologna; Bologna Italy
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Li X, Liu Y, Zhang E, He Q, Tang YB. Liver Transplantation in Antituberculosis Drugs-Induced Fulminant Hepatic Failure: A Case Report and Review of the Literature. Medicine (Baltimore) 2015; 94:e1665. [PMID: 26656321 PMCID: PMC5008466 DOI: 10.1097/md.0000000000001665] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The antituberculosis drugs isoniazid (INH), rifampicin (RMP), pyrazinamide (PZA), and ethambutol (EMB) usually expose patients to the risk of fulminant hepatic failure (FHF). This report presents a case of liver transplantation in antituberculosis drugs-induced FHF and reviews the relevant literature. A 39-year-old woman with pelvic and salpinx tuberculosis experienced complex pelvic exenteration. After the operation, she was administrated INH, RMP, PZA, and EMB to prevent tuberculosis. Two months later, examination revealed severe FHF and the antituberculosis therapy regimen was changed to ciprofloxacin and streptomycin. Subsequently, urgent orthotopic liver transplantation was performed. Posttransplantation, her serum transaminases improved gradually, but her total bilirubin level and direct bilirubin level continued to worsen, which may have been related to the rejection. However, irreversible damage from antituberulosis drugs was note excluded. Two liver biopsies and histological examinations were performed. One year after transplantation, she died as a consequence of ischemic cholangitis and pulmonary infection. A literature review revealed 9 other published cases of antituberculosis drugs-associated FHF with liver transplantation.This report suggests that, in most cases of antituberculosis drugs-induced FHF, discontinuation of toxic drugs and orthotopic liver transplantation are always sufficient treatment.
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Affiliation(s)
- Xiaoyan Li
- From the Department of Clinical Pharmacology, The Sixth Affiliated Hospital (XL), Department of Breast Surgery, Sun Yat-Sen Memorial Hospital (YL), Department of Clinical Pharmacology, The Third Affiliated Hospital (EZ), Department of Pathology, The First Affiliated Hospital (QH), and Department of Pharmacology, Cardiac and Cerebral Vascular Research Center, Zhongshan School of Medicine (YT), Sun Yat-Sen University, Guangzhou, Guangdong, China
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5
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Acute liver failure in a pediatric patient with disseminated tuberculosis. Dig Dis Sci 2011; 56:2780-3. [PMID: 21695402 DOI: 10.1007/s10620-011-1776-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 06/01/2011] [Indexed: 12/09/2022]
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Abstract
Antibiotics used by general practitioners frequently appear in adverse-event reports of drug-induced hepatotoxicity. Most cases are idiosyncratic (the adverse reaction cannot be predicted from the drug's pharmacological profile or from pre-clinical toxicology tests) and occur via an immunological reaction or in response to the presence of hepatotoxic metabolites. With the exception of trovafloxacin and telithromycin (now severely restricted), hepatotoxicity crude incidence remains globally low but variable. Thus, amoxicillin/clavulanate and co-trimoxazole, as well as flucloxacillin, cause hepatotoxic reactions at rates that make them visible in general practice (cases are often isolated, may have a delayed onset, sometimes appear only after cessation of therapy and can produce an array of hepatic lesions that mirror hepatobiliary disease, making causality often difficult to establish). Conversely, hepatotoxic reactions related to macrolides, tetracyclines and fluoroquinolones (in that order, from high to low) are much rarer, and are identifiable only through large-scale studies or worldwide pharmacovigilance reporting. For antibiotics specifically used for tuberculosis, adverse effects range from asymptomatic increases in liver enzymes to acute hepatitis and fulminant hepatic failure. Yet, it is difficult to single out individual drugs, as treatment always entails associations. Patients at risk are mainly those with previous experience of hepatotoxic reaction to antibiotics, the aged or those with impaired hepatic function in the absence of close monitoring, making it important to carefully balance potential risks with expected benefits in primary care. Pharmacogenetic testing using the new genome-wide association studies approach holds promise for better understanding the mechanism(s) underlying hepatotoxicity.
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Affiliation(s)
- Raúl J Andrade
- Hepatology Unit, Gastroenterology Service, Virgen de la Victoria University Hospital Department of Medicine, University of Málaga, Spain
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Perriot J, Chambonnet E, Eschalier A. [Managing the adverse events of antitubercular agents]. Rev Mal Respir 2011; 28:542-55. [PMID: 21549908 DOI: 10.1016/j.rmr.2010.10.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 10/05/2010] [Indexed: 02/08/2023]
Abstract
Tuberculosis, an infectious disease which is curable by following a course of antibiotics, remains a major public health issue on a global scale. A therapeutic strategy has been standardised which calls for the use of four antibiotics. These are generally well-tolerated but, individually and in combination, frequently have undesirable effects. Isoniazid may cause hepatic toxicity and an also be an asue of peripheral neuropathy. Rifampin is a strong hepatic enzyme inducer and can be responsible for severe immunoallergic reactions in the case of interrupted treatment. Pyrazinamide sometimes results in severe hepatotoxicity. Ethambutol can be responsible for severe ocular toxicity. Both older antituberculous medications and new generation antibiotic medications used for the treatment of resistant bacilli can also be the source of adverse events. The treatment of tuberculosis is standardised but the decision to treat it is inseparable from the evaluation of possible side effects which require assessment prior to the initiation of therapy and close monitoring during treatment which includes ensuring that patients are aware of and vigilant for potential problems.This work describes the adverse events of different antibiotic medications so that, on an individual basis they can be anticipated and appropriately managed.
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Affiliation(s)
- J Perriot
- Dispensaire Émile-Roux, centre de lutte antituberculeux du Puy-de-Dôme 63, 11, rue Vaucanson, 63100 Clermont-Ferrand, France.
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Ichai P, Saliba F, Antoun F, Azoulay D, Sebagh M, Antonini TM, Escaut L, Delvart V, Castaing D, Samuel D. Acute liver failure due to antitubercular therapy: Strategy for antitubercular treatment before and after liver transplantation. Liver Transpl 2010; 16:1136-46. [PMID: 20879012 DOI: 10.1002/lt.22125] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The standard antitubercular treatment (ATT), which consists of isoniazid (INH), rifampicin (RIF), ethambutol, and pyrazinamide (PZA), is the best available treatment for tuberculosis (TB). However, the hepatotoxicity of INH and PZA can be severe, and even after drug withdrawal, patients may require liver transplantation (LT). In these cases, the strategy for the treatment of TB is poorly defined. Between 1986 and 2008, 14 patients presented at our department with severe hepatitis secondary to INH and PZA treatment. Four of these patients were immunosuppressed: 2 after renal transplantation and 2 because of human immunodeficiency virus infection. In seven of the 14 patients an alternative ATT was begun on admission, which was well tolerated. Hepatitis improved spontaneously in 5 patients, and alternative ATT was continued for 9.3 ± 4.2 months; 1 patient deteriorated and underwent LT, and 1 patient died. ATT was stopped definitively in 2 patients. Six patients required urgent LT, and alternative ATT was started after transplantation and was successful. Five patients receiving RIF had an episode of acute rejection. In conclusion, hepatitis secondary to ATT can be successfully treated with alternative anti-TB regimens. The use of RIF in LT patients may lead to acute rejection. RIF should therefore be avoided in these patients.
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Affiliation(s)
- Philippe Ichai
- Centre Hépato-BiliaireAP-HP Hôpital Paul Brousse, Villejuif, France.
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Cramer JP, Lohse AW, Burchard GD, Fischer L, Nashan B, Zimmermann M, Marx A, Kluge S. Low N-acetyltransferase 2 activity in isoniazid-associated acute hepatitis requiring liver transplantation. Transpl Int 2010; 23:231-3. [DOI: 10.1111/j.1432-2277.2009.00921.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Schneider R, Bercker S, Schubert S, Tillmann H, Fangmann J, Hauss J, Bartels M. Successful Liver Transplantation in Antituberculosis Therapy–Induced Acute Fulminant Hepatic Failure. Transplant Proc 2009; 41:3934-6. [DOI: 10.1016/j.transproceed.2009.01.118] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Revised: 10/29/2008] [Accepted: 01/08/2009] [Indexed: 11/25/2022]
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Holty JEC, Gould MK, Meinke L, Keeffe EB, Ruoss SJ. Tuberculosis in liver transplant recipients: a systematic review and meta-analysis of individual patient data. Liver Transpl 2009; 15:894-906. [PMID: 19642133 DOI: 10.1002/lt.21709] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Mycobacterium tuberculosis (MTB) causes substantial morbidity and mortality in liver transplant recipients. We examined the efficacy of isoniazid latent Mycobacterium tuberculosis infection (LTBI) treatment in liver transplant recipients and reviewed systematically all cases of active MTB infection in this population. We found 7 studies that evaluated LTBI treatment and 139 cases of active MTB infection in liver transplant recipients. Isoniazid LTBI treatment was associated with reduced MTB reactivation in transplant patients with latent MTB risk factors (0.0% versus 8.2%, P = 0.02), and isoniazid-related hepatotoxicity occurred in 6% of treated patients, with no reported deaths. The prevalence of active MTB infection in transplant recipients was 1.3%. Nearly half of all recipients with active MTB infection had an identifiable pretransplant MTB risk factor. Among recipients who developed active MTB infection, extrapulmonary involvement was common (67%), including multiorgan disease (27%). The short-term mortality rate was 31%. Surviving patients were more likely to have received 3 or more drugs for MTB induction therapy (P = 0.003) and to have been diagnosed within 1 month of symptom onset (P = 0.01) and were less likely to have multiorgan disease (P = 0.01) or to have experienced episodes of acute transplant rejection (P = 0.02). Compared with the general population, liver transplant recipients have an 18-fold increase in the prevalence of active MTB infection and a 4-fold increase in the case-fatality rate. For high-risk transplant candidates, isoniazid appears safe and is probably effective at reducing MTB reactivation. All liver transplant candidates should receive a tuberculin skin test, and isoniazid LTBI treatment should be given to patients with a positive skin test result or MTB pretransplant risk factors, barring a specific contraindication. Liver Transpl 15:894-906, 2009. (c) 2009 AASLD.
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Affiliation(s)
- Jon-Erik C Holty
- Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA.
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Abstract
PURPOSE OF REVIEW To identify the key publications of 2006 dealing with drug-induced liver injury. RECENT FINDINGS When given in therapeutic doses over 14 days, acetaminophen produced significant asymptomatic elevations in alanine aminotransferase among healthy volunteers, suggesting that subclinical injury may be more common than previously thought. Acute liver failure in children was shown to differ in several important respects from that seen in adults, notably a much lower incidence of acetaminophen toxicity with nearly half of all cases being indeterminate in origin. The first cases of hepatotoxicity with telithromycin, a new class of ketolide antibiotic, were described along with reports suggesting liver injury from ezetimibe among other agents. The potential for chronic injury to develop after acute drug-induced liver injury was analyzed in a large Swedish database; 5-6% of cases were judged to become chronic, with drugs causing cholestatic injury predominating. Among well described hepatotoxins, new reports appeared with highly active antiretroviral therapy agents, herbal therapies and several antibiotics. Finally, the safe use of pravastatin and pioglitazone was demonstrated in patients with chronic liver disease in controlled clinical trials. SUMMARY Drug-induced liver injury remains an important concern for many existing drugs as well as for agents in development.
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Affiliation(s)
- Cherinne Arundel
- Division of Gastroenterology, Section of Hepatology, Georgetown University Medical Center, Washington, DC 20007, USA
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Moon DS, Jang TW, Oak CH, Jung MH, Yoo CH, Song JY, Kim SE, Kim JK, Jang LL, Lee EY, Jung GS. A Case of Pyrazinamide Induced Fulminant Hepatic Failure. Tuberc Respir Dis (Seoul) 2007. [DOI: 10.4046/trd.2007.63.5.435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Dae Sung Moon
- Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea
| | - Tae Won Jang
- Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea
| | - Chul Ho Oak
- Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea
| | - Maan Hong Jung
- Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea
| | - Chan Hui Yoo
- Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea
| | - Jun Young Song
- Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea
| | - Sung Eun Kim
- Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea
| | - Ja Kyung Kim
- Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea
| | - Lee La Jang
- Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea
| | - Eun Young Lee
- Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea
| | - Gyu Sik Jung
- Department of Radiology, College of Medicine, Kosin University, Busan, Korea
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