Abstract

CARLIN RONQUILLO, Andrea; ALVIZURI GOMEZ, Claudia  and  GARCIA-ENCINAS, Carlos. Adverse reactions to antituberculosis drugs presenting as DRESS syndrome and acute liver failure. Rev. gastroenterol. Perú [online]. 2022, vol.42, n.2, pp.136-138. ISSN 1022-5129.  http://dx.doi.org/10.47892/rgp.2022.422.1344.

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.

Keywords : Drug hypersensitivity syndrome; Antibiotics, antitubercular; Liver failure, acute.

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