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Hypersensitivity myocarditis induced by isoniazid overdose in a 15-year-old girl: a case report

Published online by Cambridge University Press:  14 October 2024

Nihal Akçay ,
Büşra Ateş ,
Neval Topal ,
Helen Bornaun Open the ORCID record for Helen Bornaun [Opens in a new window] ,
Demet Tosun Open the ORCID record for Demet Tosun [Opens in a new window]  and
İlyas Bingöl
Nihal Akçay
Affiliation:
Department of Pediatric Intensive Care Unit, University of Health Sciences Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
Büşra Ateş
Affiliation:
Department of Pediatrics, University of Health Sciences Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
Neval Topal
Affiliation:
Department of Pediatrics, University of Health Sciences Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
Helen Bornaun
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
Demet Tosun*
Affiliation:
Department of Pediatric Intensive Care Unit, University of Health Sciences Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
İlyas Bingöl
Affiliation:
Department of Pediatric Intensive Care Unit, University of Health Sciences Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
*
Corresponding author: Demet Tosun; Email: [email protected]
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Abstract

Introduction:

Myocarditis represents a diverse group of inflammatory diseases affecting the heart muscle, with both infectious and non-infectious etiologies. Among the non-infectious causes, drug-induced hypersensitivity reactions are rare but serious. Isoniazid, a cornerstone in tuberculosis treatment, is known for its hepatotoxicity but has rarely been documented to cause hypersensitivity myocarditis.

Case report:

We present a case of a 15-year-old girl from Eastern Turkmenistan who was admitted to our emergency department with altered consciousness and seizure activity. She was diagnosed with status epilepticus and treated accordingly. The patient, with no prior medical history, was found to have hypotensive shock and myocarditis upon further examination. A detailed history revealed she had ingested 45 tablets of expired isoniazid in a suicide attempt. She was treated with pyridoxine and supportive therapies, resulting in a gradual recovery.

Conclusion:

This case underscores the critical need to consider drug-induced hypersensitivity myocarditis in the differential diagnosis of myocarditis, especially in patients with recent medication use. Prompt recognition and appropriate treatment with pyridoxine, steroid, and supportive cardiac care can be lifesaving. This case also highlights the importance of awareness regarding the potential cardiotoxic effects of isoniazid overdose.

Keywords

Isoniazidoverdosemyocarditis
Type
Brief Report
Information
Cardiology in the Young , Volume 34 , Issue 11 , November 2024 , pp. 2487 - 2490
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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