Anti Tubercular Drug Induced Liver Disease: A Case Report In A Tertiary Care Teaching Hospital

ABSTRACTTuberculosis is one among the serious public health challenge worldwide. Among broad range of drugs that are known to induce liver damage, hepatotoxic side effects are serious challenges in patients receiving Anti-TB medications.  First line agents that are used for treating this condition induce various adverse effects including liver injury, skin reactions, and gastrointestinal reactions. However in addition to individual risk factors like age, gender and  hypo albunemia, use of anti tubercular drugs in combination enhances the degree of toxicity as each drug possess varying degree of liver toxicity. Drug induced liver injury (DILI) is the most common and serious adverse reaction caused due to the use of ATT regimen that needs vigilant monitoring in preventing fatal complications. Here we present a case of hepato toxicity induced by use of ATT (Rifampicin 450 mg, Isoniazid 75 mg, Pyrazinamide 400 mg and Ethambutol 275 mg OD) for a period of one month later on which she experienced drug hypersensitivity reactions and altered liver function tests. The suspected ADR was probable ADR (Naranjo’s scale). Offending drug regimen was stopped and second line agents (SLE regimen) along with supportive care were given. Hence it is often essential that clinicians regularly evaluate patients for these conditions to prevent their emergence and progression.Keywords: ATT (anti tubercular therapy), DILI (drug induced liver injury), Hepato toxicity, Tuberculosis, SLE (streptomycin, Levofloxacin, Ethambutol)