病例报告
Meng Lina;Zhang Yuxiang;Su Jinwen;Yu Jinggang;Chen Ling
2011, 13(2): 118-2.
A 75yearold male patient with pulmonary tuberculosis was treated with rifampicin 0.6 g once daily, isoniazid 0.3 g once daily; pyrazinamide 03 g thrice daily, and levofloxacin 0.2 g twice daily for pulmonary tuberculosis. Eleven days later, the patient developed red rash accompanied with a maximum temperature of 38 ℃ and,14 days later, the symptoms worsened, so he stopped taking the medicines himself. Subsequently, he had jaundiced skin and sclera, vomiting, edema, and then he was hospitalized. Laboratory tests showed the following levels and values: ALT 652 U /L, AST 5066 U/L, ALP 66 U/L, DBil 30.9 μmol/L, TBil 53.5 μmol/L, SCr 150.0 μmol/L, BUN 13.9 mmol/L, platelet count 65×109/L. Admission diagnosis was as follows: secondary pulmonary tuberculosis; druginduced liver injury; type 1 respiratory failure; renal dysfunction; fibrillation; multiple organ dysfuction syndrome. All antitubercular drugs were discontinued, he was given amiodarone, diphenhydramine, calcium gluconate, hydrocortisone, S-adenosine-L-methionine, as well as other symptomatic and supportive treatments. Two weeks after hospitalization, the patient improved markedly. Laboratory tests showed the following results: ALT 36 U/L, AST 29 U/L, DBil 27.6 μmol/L, TBil 45.5 μmol/L, platelet count 93×109/L, SCr 51.5 μmol/L, and BUN 10.1 mmol/L. Antitubercular treatment was readministered as follows: ethambutol 075 g once daily and, one week later, pyrazinamide 0.1 g thrice daily was added and, 2 weeks later, isoniazid 0.3 g once daily was added. One month after admission, the patient’s condition was stable, and then he was discharged