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Case Report
A Case of Seizure and Metabolic Acidosis Due to Renal Adjustment Dosage of Isoniazid in an Elderly Woman - Young Shin Shin1, Eun Hee Sim1, Chang Woo Yeo1, Jin Doo Kang1, Ji Yeon Kim1, Seon Ja Park2
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Kosin Medical Journal 2014;29(1):63-68.
DOI: https://doi.org/10.7180/kmj.2014.29.1.63
Published online: December 17, 2014
1Department of Internal Medicine, Dae-Dong Hospital, Busan, Korea
2Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea
- Corresponding Author: Ji Yeon Kim, Deparment of Internal Medicine, Dae-Dong Hospital, 187 Chungyel-daero, Dongrae-gu, Busan, 607-711, Korea TEL: +82-10-9323-9669 FAX: +82-51-553-7575 E-mail: bbuss36@naver.com
• Received: March 7, 2013 • Revised: May 26, 2013 • Accepted: July 10, 2013
Copyright © 2014 Kosin University School of Medicine Proceedings
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
- Isoniazid is one of the most commonly used antituberculosis drug. Acute into xication is characterized by repetitious convulsions, high anion gap metabolic a cidosis and coma. The basis of theraphy consists of parental pyridoxine admi nistration in a dose equivalent to that of isoniazid ingested. Here we present a case of seizure and metabolic acidosis due to only renal adjustment dosage of Isoniazid in an elderly woman.
Fig. 1.Non-enhanced abdominal CT scan demonstrates lytic destructive change in Thoracic vertebral body.
Fig. 2.T2-weighted sagittal MRI of spine demonstrates destruction of T10, T 11, T12 bodies due to spinal tuberculosis and secondary to abscess formation.
Table 1.Serial of arterial blood gas analysis
| HD#10∗ | HD#10† | HD#10‡ | HD#10§ | HD#11 (2)¶ | HD#12 (3)¶ | HD#13 (4)¶ | HD#14 (5)¶ | |
|---|---|---|---|---|---|---|---|---|
| pH | 7.261 | 7.064 | 7.187 | 7.210 | 7.266 | 7.327 | 7.411 | 7.445 |
| PaCO2 (mm | mHg) 21 | 52.3 | 56.7 | 50.6 | 47.4 | 45 | 42.2 | 36.6 |
| PaO2 (mmH | Hg) 95.5 | 116.1 | 68.1 | 89.5 | 98.5 | 95.5 | 111.1 | 87.3 |
| HCO3-(mmo | ol/L) 14.1 | 14.9 | 18.9 | 20.0 | 21.1 | 23.3 | 26.2 | 24.6 |
| Base exces | s -13.1 | -15.2 | -9.5 | -8.1 | -5.9 | -2.9 | 1.6 | 0.5 |
Table 2.Comparison of laboratory examination findings before and after administrating antituberculosis agents
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