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Review Systemic polyarteritis nodosa following hepatitis B vaccination. 2008
de Carvalho JF, Pereira RM, Shoenfeld Y. · Rheumatology Division, São Paulo University School of Medicine, São Paulo, Brazil. · Eur J Intern Med. · Pubmed #19046721 No free full text.
Abstract: The authors report a patient who developed systemic polyarteritis nodosa two months after hepatitis B vaccination and review the literature concerning this vaccination and the development of autoimmune conditions, mainly vasculitis. A 14-year-old boy who had no relevant previous history and who was not taking any drugs presented with a livedo reticularis, fever, loss of weight, testicular pain, and paresthesias two months after receiving the third dose of a hepatitis B vaccination. Inflammatory parameters (ESR and CRP) were high. The patient met the ACR diagnostic criteria for polyarteritis nodosa. He received corticosteroids and immunosuppressants and showed improvement. After reviewing the 27 cases of vasculitis after hepatitis B vaccination reported in the current literature, the authors suggest that, in some cases, vaccination may be the triggering factor for vasculitis in individuals with a genetic predisposition. Physicians should be aware of this possible association.
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Article [Isoniazid-induced hepatic failure. Report of a case] 2000
Pereira RM, Tresoldi AT, Hessel G. · Departamento de Pediatria da Faculdade de Ciências Médicas, Universidade Estadual de Campinas. · Arq Gastroenterol. · Pubmed #10962632 No free full text.
Abstract: Isoniazid and pyrazinamide are both well-known hepatotoxic drugs. When isoniazid is used, the hepatic lesion appears before than when pyrazinamide is used. This paper intends to relate a case of a 5-month-old patient who had lungs' and meningeal tuberculosis and who developed toxic hepatitis accomplished by hepatic failure while he was being treated with isoniazid, pyrazinamide and rifampicin. The clinic manifestations and the laboratory alterations were detected in the fifth day of treatment and the recovery was fast; and almost complete by the end of the first week, in which the use of isoniazid had been suspended. Although it was necessary to take the patient to the intensive care unit, he had a good recovery, without sequels.
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