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KMID : 0383820070630050435
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Tuberculosis and Respiratory Diseases
2007 Volume.63 No. 5 p.435 ~ p.439
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A Case of Pyrazinamide Induced Fulminant Hepatic Failure
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Moon Dae-Sung
Jang Tae-Won
Oak Chul-Ho
Jung Maan-Hong
Yoo Chan-Hui
Song Jun-Young
Kim Sung-Eun
Kim Ja-Kyung
Jang Li-La
Lee Eun-Young
Jung Gyu-Sik
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Abstract
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Standard antituberculous therapy, including isoniazid (INH), rifampin, ethambutol, and pyrazinamide (PZA), is
widely used to treat active tuberculosis. The most important side effect is hepatotoxicity. In a standard four-drug
regimen, PZA was the most common cause of drug-induced hepatitis and was dose-related. The incidence of
drug-induced hepatitis is high at doses of 40∼70 mg/kg per day but has fallen significantly since the recommended
dose was reduced. Liver toxicity induced by PZA is rare at doses of 25 mg/kg per day or less. PZA-induced
fulminant hepatic failure is also rare but fatal. We report a case of fulminant hepatic failure caused by a re-challenge
of PZA.
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KEYWORD
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Drug induced hepatitis, Fulminant hepatic failure, Pyrazinamide
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