Adverse reactions to antituberculosis drugs presenting as DRESS syndrome and acute liver failure

• Autores: Carlin Ronquillo, Andrea, Alvizuri Gómez, Claudia, García Encinas, Carlos
• Formato: artículo
• Fecha de Publicación: 2022
• Institución: Sociedad de Gastroenterología del Perú
• Repositorio: Revista de Gastroenterología del Perú
• Lenguaje: inglés
• OAI Identifier: oai:ojs.revistagastroperu.com:article/1344
• Enlace del recurso: http://www.revistagastroperu.com/index.php/rgp/article/view/1344
• Nivel de acceso: acceso abierto
• Materia: Drug Hypersensitivity Syndrome; Antibiotics; Antitubercular; Liver Failure; Acute; Síndrome de hipersensibilidad a medicamentos; Antibióticos antituberculosos; Fallo hepático agudo

Drug induced liver injury (DILI) can be can be triggered by many medications including antituberculosis drugs. We present the case of a 37-year-old woman with a smear- positive pulmonary tuberculosis who started treatment with first-line antituberculosis drugs and 4 weeks later presented jaundice, somnolence and a morbilliform generalized rash with progressive neurologic deterioration which had a fatal outcome. Antituberculosis drugs can cause DILI in 2 to 28% of patients and drug reaction with eosinophilia and systemic symptoms (DRESS syndrome) in 1.2%. Acute liver failure (ALF) can occur in 35% of patients with DILI with an overall mortality of 9.7%. If the ALF is unresponsive to medical treatment, liver transplantation has shown promising results and can avoid progression of complications. DILI can be a serious medical condition in patients receiving antituberculosis drugs. If ALF develops and is unresponsive to medical treatment, liver transplantation should be considered as the treatment of choice.