Isoniazid intoxication presenting as status epilepticus, hyperglycemia, severe metabolic acidosis and hepatotoxicity

Abstract

Isoniazid (isonicotinic acid hydrazide [INH]) is an antimicrobial that has been used as a firstline agent for prophylaxis and treatment of tuberculosis. Since isoniazid is increasingly being used to control the spread of tuberculosis, physicians must be aware of its potentially fatal effects. An acute overdose is potentially fatal and is characterized by the clinical triad of repetitive seizures unresponsive to the usual anticonvulsants, metabolic acidosis with a high anion gap and coma. The diagnosis of INH overdose should be considered in any patient who presents to emergency medical services with the triad. We report a patient presenting with multiple generalized tonic clonic convulsions with severe metabolic acidosis and hyperglycemia as a manifestation of INH toxicity

Keywords

• isoniazid
• intoxication
• tonic clonic convulsion
• metabolic acidosis
• hepatotoxicity

Status epileptikus, hiperglisemi, ciddi metabolik asidoz ve hepatotoksisite ile prezente olan izoniazid intoksikasyonu

Abstract

İzoniazid (izonikotinik asit hidrazid [INH]) bir antimikrobiyal olup tüberküloz profilaksi ve tedavisinde ilk seçenek ajan olarak kullanılmaktadır. Tüberkülozun yayılımını kontrol altına almada İzoniazid’in artan kullanımından dolayı klinisyen ilacın potansiyel fatal etkilerinin farkında olmalıdır. Akut yüksek doz antikonvulzanlara cevap vermeyen tekrarlayıcı nöbetler, yüksek anyon gapli metabolik asidoz ve koma ile seyreden triad ile karakterizedir ve potansiyel fatal olabilir. Izoniazid yüksek doz alımı acil servise bu triadla gelen her hastada düşünülmelidir. Biz de burada multipl, jeneralize, tonikklonik nöbet, ciddi metabolik asidoz ve hiperglisemi ile prezente olan INH toksikasyonu vakasını sunduk.

Keywords

• izoniazid
• intoksikasyon
• tonik klonik konvulzyon
• metabolik asidoz
• hepatotoksisite

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