Liver enzyme disturbances during isoniazid chemoprophylaxis in children.

Abstract

In 25 of 369 children (6.8 per cent) receiving isoniazid for tuberculosis chemoprophylaxis, serum glutamic oxaloacetic transaminase (SGOT) increased to a concentration greater than 50 units 2 months after medication was begun. There was no other evidence of hepatotoxicity. Isoniazid was discontinued in 4 children with SGOT of more than 95 units. Three of these 4 later resumed and completed isoniazid treatment with smaller, reversible changes in SGOT. The fourth child did not resume medication for nonmedical reasons. In the remaining 21 children with smaller increases of SGOT (50 to 95 units), the SGOT concentration soon decreased during uninterrupted isoniazid administration. None of the 7 children with increases in SGOT who were phenotyped for isoniazid inactivation were rapid inactivators. It is possible that giving a lower dose of isoniazid to slow acetylators might decrease the incidence of hepatotoxicity in programs using isoniazid for the prophylaxis of tuberculosis.