PRÉVALENCE DE L'HÉPATITE CYTOLYTIQUE SECONDAIRE AUX ANTIBACILLAIRES AU COURS DES MÉNINGITES TUBERCULEUSES

Objective : The aim of this work was to specify the prevalence and the description of secondary cytolytic hepatitis of the antituberculous drugs used in treatment of tuberculous meningitis in the intensive care unites. Method : We hove been included retro-spectively (January 1998 - december 2002) patients having a tuberculous meningitis treated with antituberculous drugs whose developed a cytolytic hepatitis defined by an increse of the alanin-aminotransferase (ALAT) level more than two times of its normal upper limit. Results : Six cases have been included among 74 patients (prevalence of 8,1%), three women and three men aged 17 to 45 years. The delay of apparition of cytolytic hepatitis varied from four days to five weeks. ALAT rates varied from two and half to 26 times to normal level. No other potentialy hepatoxic medication has been prescribed. Three patients normalized their ALAT after reducing the rifampcin dose to half measure in another case a definitive stoppage of isoniazid was required. Cytolytic hepatitis regressed spotaneously in one patient whereas another died as a result of a nosocomial infection. Conclusion : The prevalence of secondary cytolytic hepatitis of antituberculous drugs during treatment of tuberculous meningitis in the intensive care units raised to 8,1% the evolution is most often favourable after adaptation of doses.