Hepatic abnormalities are the most common side effects seen in patients taking standard antitubercular (isoniazid, rifampicin, ethambutol and pyrazinamide) therapy. These abnormalities can range from liver enzyme abnormalities to fulminant hepatic failure.The drug itself or its metabolites can cause this damage with a direct toxic effect or immunologic mechanisms. Underlying liver disease, alcohol intake, malnutrition or presence of other systemic diseases can facilitate the liver damage as well as enhancing the severity and worsen the progress. Here, we will discuss a female patient who developed hepatotoxicity with a sudden onset of serious ascites at the end of the first month of antitubercular treatment.
Keywords: Antitubercular therapy, hepatotoxicity, diffuse ascites