Introduction:
Tuberculosis (TB) is a major public health problem in developing countries. However the use of anti-tubercular drug can cause various side effects like aplastic anaemia which is a serious bone marrow disorder leading to fatal consequences especially when it occurs in a patient with risk factor like chronic kidney disease.
Methods:
Results:
This case reports a patient of 39 years with past medical history of hypertension on medication since 1.5 year and on maintenance hemodialysis for past 1 year, now he is diagnosed with tubercular lymphadenitis and was initiated with tubercular fixed combination quadruple therapy (isoniazid, rifampicin, pyrazinamide and ethambutol). Then the patient presented with rashes on the skin and oral thrush since day 14 after the initiation of treatment. And blood picture showed pancytopenia. Then anti-tubercular drugs were discontinued as it was suspected to be due to a complication related to ATT. Subsequently patient developed fever and hypotension, so antibiotic and antifungal were started. And to rule out the cause, bone marrow examination was suggested which revealed aplastic anemia. Then patient was stabilized by transfusion of whole blood and platelet. After stabilization, ATT was reintroduced in a phasewise manner. But after reintroduction of rifampicin similar symptoms of rashes reappeared which gave the strong likelihood of rifampicin being responsible for this complication.So rifampicin was discontinued. No recurrence of the symptoms occurred. Thus, the diagnosis of rifampicin-induced aplastic anaemia appears to have been confirmed and the patient tolerated the remainder of their treatment well.
Conclusions:
The diverse haematological abnormalities observed in TB patients suggests the need for continuous monitoring and evaluation of TB patients for adverse drug reactions during treatment.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.