Mania induced by isoniazid preventive therapy during steroid treatment for rheumatoid arthritis and organising pneumonia

BMJ Case Rep. 2019 Nov 2;12(11):e231919. doi: 10.1136/bcr-2019-231919.

Abstract

Isoniazid preventative therapy is widely used for latent tuberculosis infection. Isoniazid is highly effective but has many adverse effects, including neuropsychiatric. We describe the case of an 80-year-old woman with mania. She had received isoniazid preventative therapy during steroid treatment for rheumatoid arthritis and organising pneumonia for the previous 5 months. Her mania resolved after discontinuation of isoniazid. Adverse effects of isoniazid should be considered even if a long time has elapsed since the start of administration. Physicians other than infectious disease and respiratory specialists also must be aware of the adverse effects of isoniazid preventative therapy.

Keywords: TB and other respiratory infections; unwanted effects/adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / adverse effects*
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / drug therapy
  • Bipolar Disorder / chemically induced*
  • Female
  • Humans
  • Isoniazid / administration & dosage
  • Isoniazid / adverse effects*
  • Latent Tuberculosis / prevention & control*
  • Pneumonia / complications
  • Pneumonia / drug therapy

Substances

  • Antitubercular Agents
  • Isoniazid