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Coma caused by isoniazid poisoning in a patient treated with pyridoxine and hemodialysis

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Abstract

Isoniazid is widely used to treat tuberculosis. In populations with a high prevalence rate of tuberculosis, acute ingestion of isoniazid has been reported as a potential cause of coma. In this study, we present the diagnosis and treatment of isoniazid poisoning in a case with acute coma as the major clinical presentation.

A 32-year-old male who ingested 12 g isoniazid (2 hours prior to medical attention) was brought to the emergency department while in a coma and experiencing frequent seizures. Initial treatment with large doses of pyridoxine (for 6 hours) failed to awaken this patient. The patient was then given hemodialysis and pyridoxine; after 3 days he awoke from coma, with no further reported seizures.

Isoniazid poisoning should be suspected in patients whose major symptoms are coma and seizure, especially those who have access to isoniazid. Monitoring the blood level of isoniazid will establish the diagnosis and help clinical management. A combination of hemodialysis and pyridoxine is effective in treating isoniazid poisoning.

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References

  1. Shannon MW, Lovejoy FH Jr. Isoniazid. In: Haddad LM, Winchester JF, eds. Clinical Management of Poisoning and Drug Overdose. 2nd edition. Philadelphia: Saunders; 1990:970–975.

    Google Scholar 

  2. Alvarez FG, Guntupalli KK. Isoniazid overdose: four case reports and review of the literature. Intensive Care Med. 1995;21:641–644.

    Article  PubMed  CAS  Google Scholar 

  3. Wood JD, Peesker SJ. The effect on GABA metabolism in brain of isonicotinic acid hydrazide and pyridoxine as a function of time after administration. J Neurochem. 1972;19:1527–1537.

    Article  PubMed  CAS  Google Scholar 

  4. Pearl PL, Gibson KM. Clinical aspects of the disorders of GABA metabolism in children. Curr Opin Neurol. 2004;17:107–113.

    Article  PubMed  CAS  Google Scholar 

  5. Orlowski JP, Paganini EP, Pippenger CE. Treatment of a potentially lethal dose isoniazid ingestion. Ann Emerg Med. 1988;17:73–76.

    Article  PubMed  CAS  Google Scholar 

  6. Siefkin AD, Albertson TE, Corbett MG. Isoniazid overdose: pharmacokinetics and effects of oral charcoal in treatment. Hum Toxicol. 1987;6:497–501.

    Article  PubMed  CAS  Google Scholar 

  7. Temmerman W, Dhondt A, Vandewoude K. Acute isoniazid intoxication: seizures, acidosis and coma. Acta Clin Belg. 1999;54:211–216.

    PubMed  CAS  Google Scholar 

  8. Wason S, Lacouture PG, Lovejoy FH Jr. Single high dose pyridoxine treatment for isoniazide poisoning. JAMA. 1981;246:1102–1104.

    Article  PubMed  CAS  Google Scholar 

  9. Lheureux P, Penaloza A, Gris M. Pyridoxine in clinical toxicology: a review. Eur J Emerg Med. 2005;12:78–85.1989;69:292–296.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Gastroenterology, Guangdong No. 2 Provincial People’s Hospital, Guangzhou, China

    Wei-Ping Tai & Hui Yue

  2. Department of Gastroenterology, The First Affiliate Hospital of Sun Yat-Sen University, Guangzhou, China

    Wei-Ping Tai & Pin-Jing Hu

Authors
  1. Wei-Ping Tai
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  2. Hui Yue
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  3. Pin-Jing Hu
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Correspondence to Wei-Ping Tai.

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Tai, WP., Yue, H. & Hu, PJ. Coma caused by isoniazid poisoning in a patient treated with pyridoxine and hemodialysis. Adv Therapy 25, 1085–1088 (2008). https://doi.org/10.1007/s12325-008-0098-7

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  • DOI: https://doi.org/10.1007/s12325-008-0098-7

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