Hepatic toxicity during chemotherapy for severe tuberculosis meningitis
P. R. Donald, J. F. Schoeman and A. O'Kennedy
The possible development of hepatotoxic effects as a result of high dosages
of isoniazid, rifampin, pyrazinamide, and ethionamide was assessed in 56
young children (median age, 22 months) treated for severe tuberculous
meningitis (TBM). Only one of the 56 children became jaundiced, probably as
result of hepatitis A infection. Of 33 children observed for at least eight
weeks, only five (15%) had normal serum aspartate aminotransferase (AST),
alanine aminotransferase (ALT), and gamma-glutamyl transferase levels
throughout, but in only three patients were AST or ALT values greater than
200 U/L, and enzyme levels tended to normalize toward the end of the
period. In this group of 33 children, those at stage III TBM had higher
enzyme levels than did those at stage II. The remaining 23 children were
observed for a mean period of only four weeks, and 18 (75%) had at least
one abnormal liver function test result.
