Man with liver and kidney failure due to allergy to anti-tuberculosis drugs

The above information was announced by Dr. Dang Khoi Nguyen, Department of Endocrinology - Nephrology, Le Van Thinh Hospital (HCMC), at the annual scientific conference on the morning of May 19.

Người đàn ông suy gan, thận do dị ứng thuốc kháng lao - Ảnh 1.

The patient's hands were scaly and swollen.

The patient is a 42-year-old man living in Ho Chi Minh City, admitted to the emergency room with fever and red skin all over his body. Medical history shows that the patient is in the second month of treatment for tuberculosis. The patient said that when he took anti-tuberculosis drugs for the seventh week, he started to have chills and red skin on his face and body, which then spread to his whole body. Not only that, he also had itching, blisters, peeling, yellow sclera, and dark urine. He then went to Le Van Thinh Hospital for emergency treatment.

At the hospital, the doctor examined and noted that the patient was responsive, had a fever of 39.5 degrees, and had yellow skin. After performing the necessary tests, the patient was transferred to the Respiratory Department for treatment with a diagnosis of allergic reaction, acute hepatitis due to anti-tuberculosis drugs, and sepsis.

After a week of treatment, the jaundice did not improve. The patient was tired, had anorexia, nausea, no urine output after catheter placement, and had a scaly rash all over his body. Therefore, he was transferred to the Department of Endocrinology - Nephrology for treatment, diagnosed with DRESS syndrome suspected to be caused by anti-tuberculosis drugs. Here, the patient suffered from sepsis, pneumonia, acute liver failure, and acute anuric renal failure. The doctors decided to combine internal medicine treatment, dual hemofiltration combined with plasma exchange. Thanks to that, the condition gradually improved.

After about 2 weeks of treatment, the patient recovered, was discharged from the hospital and was followed up as an outpatient. However, it was not until 3 months later that the patient's liver and kidney function returned to normal limits.

According to Dr. Nguyen, up to now, along with Stevens-Johnson syndrome, DRESS syndrome is defined as a severe adverse drug reaction that affects multiple organs and can lead to death. In this syndrome, the liver is most damaged, ranging from 51-87% with levels ranging from mild to acute liver failure.

Liver transplantation is the only definitive treatment for patients who do not recover on their own. However, only a small proportion of patients have access to this treatment. The survival rate for cases of acute liver failure without a liver transplant is less than 25%.

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