Isoniazid Induced Hepatitis and Psychosis in a Single Patient – Case report

Abstract

A 22-year-old female who was a known case of tubercular meningitis on anti-tubercular therapy, presented to the emergency room with complaints of recurrent vomiting, markedly reduced appetite, yellowish discoloration of eyes, abnormal behaviour and delusion of reference. There was no prior history of psychiatric illness or hepatitis like illness. Her liver enzymes were elevated more than 3 times of reference value and mental status examination revealed features of acute psychosis. Hepatitis resolved completely after isoniazid was discontinued and psychosis resolved fully only after treatment with amisulpride was begun. The patient was later rechallenged with isoniazid successfully and remained symptom-free 3 months after discharge from the hospital. This is an unusual presentation where both hepatitis and psychosis due to isoniazid occurred together simultaneously.