Anti-tuberculosis drug-induced hepatitis in renal transplant patient with pulmonary and extra pulmonary tuberculosis

摘要

Hepatotoxicity is a major side-effect of the medicines used in tuberculosis therapy. Although the guidelines for the management of antituberculosis drug induced hepatitis have been published from varieties of health institutes and organizations, they are to a great extent highly similar, there are nevertheless some important differences. We report a case of hepatitis in a renal transplant recipient admitted with pulmonary and extra pulmonary (abdominal) tuberculosis and review the literature on this topic. The introduction of antimicrobial teams, including specialist pharmacists, microbiologists and infectious disease physicians, is a major factor to improve the quality of care and faces the overcoming of antimicrobial resistance. Reintroducing one antituberculosis drug at a time with close monitoring of liver enzymes seems to be the optimal approach in the management of antituberculosis drug induced hepatitis. With multi-disciplinary clinical approach the patient has been successfully cured and has returned to normal active life.