ethionamide and Drug-Hypersensitivity

Topics: Acne Vulgaris; Adult; Amikacin; Antitubercular Agents; Drug Hypersensitivity; Ethambutol; Ethionamide; Female; Humans; Isoniazid; Male; Middle Aged; Pellagra; Pigmentation Disorders; Prothionamide; Pyrazinamide; Rifampin; Skin Diseases; Streptomycin; Thioacetazone

Topics: Aminosalicylic Acids; Animals; Cycloserine; Drug Hypersensitivity; Drug Resistance, Microbial; Ethionamide; Geography; Guinea Pigs; Hematopoietic System; Humans; Isoniazid; Mice; Microbial Sensitivity Tests; Mycobacterium tuberculosis; Skin Manifestations; Streptomycin; Thioacetazone; Tuberculosis

In a controlled trial in Hong Bong, 575 Chinese patients with pulmonary tuberculosis whose treatment with first-line regimens had failed were allocated at random to the following retreatment regimens of chemotherapy. (1) Rifampicin plus ethambutol daily (ER7). (2) Rifampicin plus ethambutol twice a week (ER2). (3) Rifampicin plus ethambutol once a week (ER1). (4) Rifampicin plus ethambutol daily for 2 months and then once a week (ER7ER1). (5) Ethionamide plus pyrazinamide plus cycloserine daily for 6 months and then ethionamide plus pyrazinamide daily (EtZC), as a control regimen. Answers to a questionnaire on allergic disease, the results of prick tests with standard allergens, ABO blood grouping, size of tuberculin response during chemotherapy, and a rifampicin patch test showed no associations with the occurrence of adverse reactions to daily or intermittent rifampicin. Mantoux testing during chemotherapy provided no evidence of an immunosuppressive effect of rifampicin. Mean platelet counts at 12 months were significantly lower than those at 3 months on the two once-weekly regimens (ER1, ER7ER1) and on the control regimen (EtZC), although still within normal limits. At 3 months, but not at 12 months, mean platelet counts on the two once-weekly regimens were significantly lower 6 hr after a dose of the regimen than they were before the dose.

Topics: ABO Blood-Group System; Blood Cell Count; China; Clinical Trials as Topic; Cycloserine; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Ethionamide; Hematocrit; Hemoglobins; Hong Kong; Humans; Pyrazinamide; Rifampin; Tuberculosis, Pulmonary

Multiple drug hypersensitivity (MDH) is an allergy to two or more chemically unrelated drugs. We present a case of MDH caused by antituberculosis agents during the treatment of tuberculous meningitis (TBM). A 64-year-old man without a history of drug allergy developed fever and severe headache. Examination of cerebrospinal fluid showed lymphocytosis, a low glucose level, and a high ADA activity, suggestive of TBM. The patient was treated with isoniazid, rifampicin, pyrazinamide, and ethambutol, and his symptoms resolved quickly. However, 20 days after the initiation of therapy, he developed remittent fever without mucocutaneous lesions. A drug-induced lymphocyte stimulation test was positive for isoniazid, rifampicin, and pyrazinamide, which was consistent with a diagnosis of MDH. All the antituberculosis drugs were replaced with levofloxacin and ethionamide, both of which have excellent cerebrospinal fluid penetration, and the fever subsided. The patient made a full recovery from TBM. Because standard antituberculosis regimens include three or four antituberculosis drugs, it is difficult to determine the culprit drug when hypersensitivity occurs. Moreover, there can be multiple causative drugs as illustrated by the present case. During a time-consuming desensitization therapy, TBM could flare up, leading to permanent neurological damage. Thus, treatment with suitable alternative drugs should be started immediately.

Topics: Antitubercular Agents; Drug Hypersensitivity; Drug Therapy, Combination; Ethambutol; Ethionamide; Humans; Immunologic Tests; Isoniazid; Levofloxacin; Lymphocyte Activation; Male; Middle Aged; Pyrazinamide; Rifampin; Treatment Outcome; Tuberculosis, Meningeal

Side-effects of antitubercular drugs were evaluated in 662 patients with tuberculosis. Simultaneously 406 of them suffered of chronic alcoholism, 94 suffered of heavy drinking and 162 were not alcohol abusers. The frequency of side-effects in patients with tuberculosis was 31.5% and 56.4% in those with concomitant alcoholism. The latter showed more frequently negative responses to streptomycin. The latter showed more frequently negative responses to streptomycin, ethionamide, rifampycin and kanamycin. They developed toxic reactions that were three times more frequent than in those without alcohol abuse and were accompanied by exacerbation of diseases of the liver, stomach, heart, CNS, peripheral nervous system.

Topics: Alcohol Drinking; Drug Hypersensitivity; Ethionamide; Humans; Isoniazid; Rifampin; Tuberculosis, Pulmonary

Topics: Clofazimine; Dapsone; Drug Hypersensitivity; Ethionamide; Humans; Leprostatic Agents; Leprosy; Rifampin; Thioacetazone

Topics: Aminosalicylic Acids; Animals; Antitubercular Agents; Capreomycin; Chemical and Drug Induced Liver Injury; Cycloserine; Deafness; Drug Hypersensitivity; Ethambutol; Ethionamide; Gastrointestinal Diseases; Goiter; Humans; Isoniazid; Kanamycin; Liver; Mental Disorders; Mice; Nervous System Diseases; Pyrazinamide; Rifampin; Streptomycin; Thioacetazone; Tuberculosis; Viomycin

Drug hepatitis occurred in 0-32 per cent of 7492 patients receiving antituberculous therapy, while the overall incidence of drug reactions was estimated at 9 per cent. PAS was the most common cause of drug hepatitis among the 38 patients analysed. The clinical, biochemical and haematological picture of antituberculous drug hepatitis was found to be fairly uniform. However, the patients with definite PAS hepatitis had lower SGOT values than those in whom there was uncertainty whether PAS or INH was implicated. Premonitory symptoms were present in all but four patients before the onset of jaundice. One or more of the features associated with dry hypersensitivity reactions, such as fever, rashes, lymphadenopathy, arthralgia, leucocytosis, eosinophilia and atypical monocytes were present in 89 per cent of cases so that confusion with viral hepatitis seldom arose. Sensitization time was less than three months in all except three patients, who were considered to be suffering from viral hepatitis. While no patients with PAS hepatitis died, the overall mortality was 17 per cent. A review of the literature stresses the frequency of asymptomatic elevations of SGOT, the value of clinical surveillance during the early months of therapy and the importance of stopping all therapy immediately warning symptoms appear.

Topics: Aminosalicylic Acids; Antitubercular Agents; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Ethambutol; Ethionamide; Female; Gastrointestinal Diseases; Humans; Isoniazid; Jaundice; Lymphatic Diseases; Male; Pyrazinamide; Skin Diseases; Streptomycin; Thioacetazone; Tuberculosis, Pulmonary

Topics: Aminosalicylic Acids; Antitubercular Agents; Arthritis; Chemical and Drug Induced Liver Injury; Child; Cycloserine; Drug Hypersensitivity; Drug Resistance, Microbial; Ethambutol; Ethionamide; Humans; Isoniazid; Kanamycin; Liver; Lupus Vulgaris; Male; Middle Aged; Pyrazinamide; Rifampin; Streptomycin; Tuberculin Test; Tuberculosis; Viomycin

Topics: Adult; Aged; Agranulocytosis; Anaphylaxis; Antitubercular Agents; Capreomycin; Cycloserine; Drug Hypersensitivity; Ethambutol; Ethionamide; Female; Humans; Isoniazid; Kanamycin; Pyrazinamide; Rifampin; Thrombocytopenia; Viomycin

Topics: Aminosalicylic Acids; Antitubercular Agents; Cycloserine; Drug Hypersensitivity; Ethambutol; Ethionamide; Humans; Isoniazid; Kanamycin; Pyrazinamide; Pyridoxine; Rifampin; Sputum; Streptomycin; Tuberculosis; Viomycin

Topics: Adult; Aminosalicylic Acids; Antitubercular Agents; Cycloserine; Drug Hypersensitivity; Drug Resistance, Microbial; Ethambutol; Ethionamide; Female; Humans; Isoniazid; Kanamycin; Male; Middle Aged; Neomycin; Oxytetracycline; Rifampin; Streptomycin; Thiosemicarbazones; Viomycin

Topics: Aminosalicylic Acids; Antitubercular Agents; Chemical and Drug Induced Liver Injury; Cycloserine; Drug Eruptions; Drug Hypersensitivity; Drug Resistance, Microbial; Drug Synergism; Ethambutol; Ethionamide; Female; Gastrointestinal Diseases; Humans; Hypothyroidism; Isoniazid; Kanamycin; Male; Microbial Sensitivity Tests; Pyrazinamide; Recurrence; Rifampin; Streptomycin; Tuberculosis, Pulmonary; Viomycin

Topics: Aminosalicylic Acids; Blood Chemical Analysis; Capreomycin; Drug Combinations; Drug Hypersensitivity; Drug Resistance, Microbial; Ethambutol; Ethionamide; Gentamicins; Humans; Isoniazid; Kanamycin; Pyrazinamide; Streptomycin; Tuberculosis, Pulmonary; Viomycin

Topics: Ambulatory Care; Aminosalicylic Acids; Antitubercular Agents; Cycloserine; Drug Hypersensitivity; Drug Resistance, Microbial; Ethionamide; Humans; Isoniazid; Pyrazinamide; Sputum; Streptomycin; Tuberculosis, Pulmonary

Topics: Aminosalicylic Acid; Aminosalicylic Acids; Antitubercular Agents; Chemical and Drug Induced Liver Injury; Chlordiazepoxide; Chlorpromazine; Drug Eruptions; Drug Hypersensitivity; Drug Therapy; Ethionamide; Geriatrics; Hematologic Diseases; Hepatitis; Imipramine; Iproniazid; Isocarboxazid; Isoniazid; Leukocytosis; Pneumonia; Prochlorperazine; Sepsis; Shock, Septic; Streptomycin; Toxicology; Tranquilizing Agents; Viomycin

Topics: Adult; Desensitization, Immunologic; Drug Hypersensitivity; Ethionamide; Female; Humans; Tuberculosis, Pulmonary

Topics: Aminosalicylic Acids; Antitubercular Agents; Drug Hypersensitivity; Drug Tolerance; Ethionamide; Humans; Isoniazid; Skin Tests; Streptomycin; Tuberculosis, Pulmonary

Topics: Aminosalicylic Acid; Aminosalicylic Acids; Biopsy; Chemical and Drug Induced Liver Injury; Cycloserine; Drug Hypersensitivity; Ethionamide; France; Hepatitis; Isoniazid; Japan; Kanamycin; Liver Function Tests; Oxytetracycline; Pathology; Prednisone; Streptomycin; Sulfisoxazole; Toxicology; Tuberculosis

Topics: Aminosalicylic Acid; Aminosalicylic Acids; Cycloserine; Drug Hypersensitivity; Drug Resistance; Drug Resistance, Microbial; Ethionamide; Isoniazid; Pyrazinamide; Sputum; Streptomycin; Toxicology; Tuberculosis; Tuberculosis, Pulmonary; Yugoslavia

Topics: Aminosalicylic Acid; Aminosalicylic Acids; Cycloserine; Drug Hypersensitivity; Drug Resistance; Drug Resistance, Microbial; Ethionamide; Isoniazid; Pyrazinamide; Streptomycin; Tuberculosis; Viomycin

Topics: Drug Hypersensitivity; Ethionamide; Meclizine; Toxicology

Topics: Amyloidosis; Antitubercular Agents; Cycloserine; Deafness; Drug Hypersensitivity; Duodenal Ulcer; Ethionamide; Isoniazid; Kidney Diseases; Liver Diseases; Neuritis; Psychotic Disorders; Pyrazinamide; Toxicology; Tuberculosis; Tuberculosis, Pulmonary; Vertigo; Viomycin

Topics: Drug Hypersensitivity; Ethionamide; Toxicology

Topics: Aminosalicylic Acid; Aminosalicylic Acids; Anaphylaxis; Anti-Bacterial Agents; Caffeine; Drug Eruptions; Drug Hypersensitivity; Ethionamide; Histamine H1 Antagonists; Hydrocortisone; Isoniazid; Norepinephrine; Streptomycin; Toxicology; Tuberculosis; Tuberculosis, Pulmonary