Hepatotoxicity and transaminase measurement during isoniazid chemoprophylaxis in children

Chemoprophylaxis with isoniazid (INH) prevents progression from tuberculosis infection to disease in >99% of children. INH is not completely free of side effects or risks, but these are uncommon. Although allergy, rash, gastrointestinal upset, peripheral neuropathy, seizures, encephalopathy and other reactions have been reported, the major side effect of INH is hepatitis. During 1993 a child was treated at our institution for fulminant hepatitis associated with INH. This prompted a review of the charts of all children treated at our children's chest clinic during the prior 2 years to assess the presentation of hepatotoxicity and the role of transaminase measurement during INH chemoprophylaxis in children.