Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Rifampin can be associated with severe adverse effects such as hepatitis, acute renal failure, hemolytic anemia, and thrombocytopenia. Thrombocytopenia has traditionally been associated with intermittent therapy. This article reports the occurrence of rifampin-associated thrombocytopenia in an indigent patient after a four-month lapse in therapy for pulmonary tuberculosis. The patient's platelet count dropped rapidly to a level of 1000/mm3 after receiving a single 600 mg dose of rifampin. After returning to a normal level of greater than 100,000/mm3, the patient's platelets again dropped to 1200/mm3 with readministration of rifampin. The long-term therapy necessary to eradicate the Mycobacterium tuberculosis organism makes economic considerations important. This patient and other indigent patients who may be poor compliers because they are unable to buy the necessary medication may be at a higher risk for adverse reactions.
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PMID:Rifampin-associated thrombocytopenia secondary to poor compliance. 272 26

The early and late results of 6 months' chemotherapy (2/INH, RMP, PZA and 4/INH, RMP) of newly detected, bacteriologically positive pulmonary tuberculosis are presented. In the initial period during hospitalisation in nonselected 290 patients 100% conversion of sputum was obtained while in the continuous out-patients' treatment 1.3% of patients were again found to have sputum positive for acid fast bacilli. Toxic reactions on drugs were found in 5.8% of patients: in 3.4% the hepatitis developed yet in all in mild course. The narrowing of medical contraindications for 6 months' regimen is suggested especially in chronic alcoholics since in 15.2% of them the therapy with 9 months' regimen had to be introduced (INH, RMP, EMB/SM). In more than 2 yrs' follow up after the end of chemotherapy in 2.4% of patients--mostly noncooperative alcoholics--the recidivation was found already a few months after discontinuation of the therapy. The problem of chronic alcoholics and noncooperative patients for short course chemotherapy is discussed. The special measures are suggested: obligatory hospitalisation during initial therapy, supervising chemotherapy in out-patients' departments as well as intermittent regimen and prolongation of 6 months' therapy.
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PMID:[Clinical study of a 6-month chemotherapy regimen in the treatment of pulmonary tuberculosis. Results approximately 2 years after completion of chemotherapy]. 279 72

In a study in Singapore, Chinese, Malay, and Indian patients with sputum-smear-positive pulmonary tuberculosis were allocated at random to daily treatment with streptomycin, isoniazid, rifampin, and pyrazinamide for 2 months (2SHRZ), 1 month (1SHRZ), or 2 months without streptomycin (2HRZ), followed, for all patients, by 3-times-weekly isoniazid and rifampin (H3R3) up to 6 months. At 2 months, the culture-negativity rate for the 2SHRZ series was statistically significantly higher than for either of the other 2 series. All 319 patients with drug-sensitive tubercle bacilli pretreatment had a favorable bacteriologic response during chemotherapy except for one 2SHRZ/H3R3 patient, and among the 300 patients assessed during 24 months of follow-up after chemotherapy there was only 1 bacteriologic relapse in each series, giving an overall therapeutic failure rate of only 1%. Thus, the 2SHRZ combination had the highest early sterilizing activity, but the potent continuation therapy compensated for the initial inferiority of the other 2 regimens. Among the 32 patients with tubercle bacilli resistant pretreatment to isoniazid, streptomycin, or both drugs, there were no failures during chemotherapy and 3 subsequent relapses among the 30 assessed during 24 months of follow-up. Eleven (3%) of the 420 patients who started chemotherapy on their allocated regimen had hepatitis with jaundice during chemotherapy. However, 2 of these had cirrhosis pretreatment and 1 was a chronic alcoholic.
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PMID:Clinical trial of three 6-month regimens of chemotherapy given intermittently in the continuation phase in the treatment of pulmonary tuberculosis. Singapore Tuberculosis Service/British Medical Research Council. 286 20

Circulating immune complexes are thought to play an essential part in the pathogenesis of necrosing angiitis. This theory also allows a role to be attributed to certain infectious agents (viral, bacterial, parasitic) in the development of periarteritis nodosa (PAN). An infectious syndrome was found in all our 9 patients, aged 26 to 69 years, with histologically confirmed PAN: previous infection (over 15 days before hospital admission): otitis, hepatitis B, tonsillitis, ascaris (Case n.7), pulmonary tuberculosis, brucellosis, seropositivity for Chlamydia trachomatis (Case n.9), paratyphoid (Case n.5), seropositivity for Yersiniosis pseudo-tuberculosis (Case n.2), seropositivity for Chlamydia trachomatis (Cases 3 and 4), seropositivity for toxoplasmosis (Cases 4 and 6), seropositivity for rubella (Case n.8). Recent infection (less than 15 days before hospital admission): staphylococcus aureus septicaemia (Case n.1); Group A betahemolytic streptococcal urinary infection (Case n.2); Group A betahemolytic streptococcal otitis media; pseudomonas aeruginosa and Klebsiella septicaemia; enterococcal cystitis (Case n.4); progressive pulmonary tuberculosis (Case n.6), acinetobacter pneumonia (Case n.9). The HBs antigen was only found in one patient (Case n.6), who had an active hepatitis.
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PMID:[The role of infection in the precipitation of periarteritis nodosa]. 290 81

The clinical, radiographic and microbiological data of 47 patients with Mycoplasma pneumoniae infection admitted to three Norfolk hospitals during a 20-month period between 1982 and 1983 have been reviewed. Thirty-nine presented with pneumonia and eight with non-pulmonary infection. The M. pneumoniae specific IgM test was positive in 42 of 45 patients tested (89 per cent); in 39 the levels were diagnostic on admission. Cold agglutinins were detected in 27 (57 per cent) and a fourfold rise in complement fixation titre was demonstrated in 13 (29 per cent). Sputum culture was positive in 12 (26 per cent). The extrapulmonary manifestations observed were haemolytic anaemia (17 per cent), Stevens Johnson syndrome (4.1 per cent), neurological abnormalities (4.1 per cent), arthritis (2.1 per cent), hepatitis (2.1 per cent) and pericarditis (2.1 per cent). One patient with multilobe pneumonia, pericardial effusion and haemolytic anaemia died. Six patients presented with a history of illness longer than a month; in three the clinical and radiographic picture suggested chronic disease (pulmonary tuberculosis, lymphoma and unresolving pneumonia). There were no distinctive clinical or radiographic features of M. pneumoniae infection. Diagnosis, therefore, relies on serological tests of which the most useful is the rapid, specific IgM test, positive in 86 per cent of the admission sera.
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PMID:The clinical spectrum and diagnosis of Mycoplasma pneumoniae infection. 373 68

Results are presented of the incidence of hepatitis, nearly always with jaundice, among 1686 patients in clinical trials of the treatment of spinal tuberculosis, of tuberculosis meningitis and of pulmonary tuberculosis with short-course regimens containing rifampicin, isoniazid, streptomycin and pyrazinamide. The incidence was high in patients treated with daily regimens of isoniazid and rifampicin: 16-39% in children with tuberculous meningitis, 10% in patients with spinal tuberculosis (non-surgical cases), and 2-8% in those with pulmonary tuberculosis. Hepatitis, in those receiving rifampicin occurred more often in slow than in rapid acetylators of isoniazid, the proportions amongst those whose acetylator phenotype had been determined being 11% of 317 slow acetylators and 1% of 244 rapid acetylators. In children with tuberculous meningitis, the risk of hepatitis with isoniazid 20 mg/kg (39%) was higher than that with 12 mg/kg (16%), and appreciably lower in patients given rifampicin twice-weekly (5%) rather than daily (21%). There was no indication that pyrazinamide contributed to the hepatic toxicity.
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PMID:Hepatic toxicity in South Indian patients during treatment of tuberculosis with short-course regimens containing isoniazid, rifampicin and pyrazinamide. 377 70

The general medical community in the United States has been rather slow in adopting short-course bactericidal chemotherapy for tuberculosis despite the clear demonstration of the advantage by several carefully controlled clinical trials. Reported herein is experience between January 1976 and December 1982 in 1,028 patients with bacteriologically proved pulmonary tuberculosis treated for nine months with isoniazid (300 mg) and rifampin (600 mg) daily for one month followed by twice-weekly isoniazid (900 mg) and rifampin (600 mg) for the other eight months. They were treated by 45 local practitioners and supervised by public health nurses through 60 Arkansas Department of Health chest clinics in the state. Outpatient therapy was mostly self-administered in the routine treatment program. Overall success was achieved in 95 percent of the 751 patients who completed therapy; in 21 (2.8 percent), sputum cultures failed to convert to negative, and 15 (2.1 percent) have had relapse since therapy was stopped. Therapy could not be completed in 26.9 percent due to deaths, drug toxicities, relocation, refusal, etc. Of 21 bacteriologic failures, 18 patients developed isoniazid resistance and were treated with additional two bactericidal drugs. Most of the relapses (nine of 15) occurred within 12 months after chemotherapy was stopped. However, four relapses occurred quite late during follow-up. Only three of 15 patients with relapse showed isoniazid resistance. Side effects of the drugs were encountered in 10.3 percent, but major toxicities occurred in 3.2 percent (hepatitis in 2.6 percent, hematologic effects in 0.6 percent). Clinical surveillance for toxicity is preferred over routine and regular biochemical monitoring. Patient acceptance of the regimen was excellent, and compliance was good. Short-course chemotherapy is effective, with low drug toxicity, reduced cost of drugs, and ease of direct supervision when needed, and is acceptable to patients in routine treatment.
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PMID:Short-course chemotherapy for tuberculosis with mainly twice-weekly isoniazid and rifampin. Community physicians' seven-year experience with mainly outpatients. 643 10

Case report on a 40 years old patient with pulmonary tuberculosis, in whom a treatment with Rifampicin plus Ethambutol has caused a transient hepatic and renal failure. By histology a chronic aggressive hepatitis and a destruction of renal tubular epithelium could be found. The etiologic role of Rifampicin is believed to be probable. Pathomechanism and differential diagnosis are discussed.
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PMID:[Liver and kidney damage in rifampicin and ethambutol treatment]. 648 86

Recent experience suggests that the duration of chemotherapy of tuberculosis can be shortened to 6-9 months, without an increase in the relapse rate, if the treatment if started with 3 or 4 drugs including isoniazid (INH), rifampicin (RMP) and pyrazinamide (PZA). In a controlled study of culture-positive advanced pulmonary tuberculosis we have compared treatment regimens with PZA in a dosage of less than 2 g and with ethambutol (EMB). 113 patients were given, in random order for 2-3 months, either PZA (25 mg/kg body weight) or EMB (25 mg/kg) together with RMP (450 or 600 mg) and INH (5 mg/kg). The last two drugs were given for a total of 9 months. Patients treated with PZA showed a (not significantly) earlier conversion to negative cultures after an average of 7 weeks. After 18 months follow-up there have been no relapses on these regimens. 2 patients, both treated with EMB, did not respond to therapy. Drug-induced hepatitis was seen in 5 patients with PZA and in 2 patients with EMB. The hepatitis was always observed during the first month of therapy and was fully reversible. Three of the 4 patients with clinically apparent hepatitis were over 70 years of age. Three patients with elevated uric acid levels had arthralgia which led in one of them to termination of therapy. The preliminary results of our study show that the treatment regimen with PZA does not lead to a higher rate of side effects if used with particular moderation in older patients.
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PMID:[Pyrazinamide versus ethambutol in short-term therapy of lung tuberculosis. A randomized study]. 665 32

The main side-effects of BCG vaccination by scarification in 511 patients with malignant melanoma since 1974 have been fatigue and exhaustion, swelling of the lymph-nodes, influenza-like symptoms, nausea and dizziness. Only in 8 patients were the side-effects more severe, requiring the cessation of treatment in some of them. One patient developed granulomatous hepatitis, another experienced a reactivation of pulmonary tuberculosis. Allergic reactions occurred in two patients. A further patient developed recurrent erysipelas in the draining areas of the scarification. In two patients we observed continuous severe joint troubles, which were not due to metastatic disease. The eighth patient developed keloids at the vaccination sites on the upper arms. One third of the patients had no side-effects. Altogether vaccinations were tolerated well by most of the patients. Nearly all of them were able to work normally.
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PMID:[Side effects of BCG immune therapy in 511 patients with malignant melanoma]. 670 81


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