Objective Isoniazid for 6 to 9 months is the most widely used form of tuberculosis (TB) preventive treatment. We aimed to assess the adverse effects of isoniazid by using the serum levels of aspartate transaminase (AST), alanine transaminase (ALT), and uric acid (SUA) in children and adolescents receiving long-term isoniazid for latent TB infection.

Methods The study included children ≤18 years of age who underwent TB preventive treatment with isoniazid (IPT) between 2015 and 2019 at a university hospital. Serum transaminase, SUA, urea, and creatinine levels of patients were measured before the initiation of IPT, 15th day, and once a month during treatment. Patients with ALT, AST, or SUA results above cut-off levels during treatment were evaluated. The final values in follow-up were included in the data analysis.

Results A total of 141 children who underwent IPT were included. In total, 70 children had family members with confirmed TB disease, and 71 children had a positive tuberculin skin test. SUA increased above cut-off values in 16 children (11.3%), and half of them had uric acid levels over 7 mg/dL. The median duration of the development of hyperuricemia was 4.0 months. ALT or AST increased above cut-off values in 23 children (16.3%). ALT was above cut-off values in seven patients, AST was high in 20 patients. The median duration to the development of AST and/or ALT levels above cut-off was 4.0 months. Two patients had hepatotoxic transaminase levels. Three patients had both elevated transaminases and SUA levels.

Conclusion Isoniazid may also cause hyperuricemia besides elevation in transaminases in children.

目的 异烟肼治疗6到9个月是最广泛使用的结核病（TB）预防性治疗形式。我们旨在通过使用血清天冬氨酸转氨酶（AST），丙氨酸转氨酶（ALT）和尿酸（SUA）的水平来评估异烟肼对长期接受异烟肼潜伏性结核感染的儿童和青少年的不良影响。

方法 该研究纳入了2015年至2019年间在大学医院接受异烟肼（IPT）预防性治疗的≤18岁的儿童。在开始IPT之前，治疗的第15天和每月一次测量患者的血清转氨酶，SUA，尿素和肌酐水平。评估患者在治疗期间ALT，AST或SUA结果高于临界水平的患者。随访中的最终值包括在数据分析中。

结果 共纳入141例接受IPT的儿童。总共有70名儿童的家庭成员确诊为结核病，而71名儿童的结核菌素皮肤试验阳性。SUA升高至超过临界值的16名儿童（11.3％），其中一半的尿酸水平超过7 mg / dL。高尿酸血症发展的中位持续时间为4.0个月。23名儿童（16.3％）的ALT或AST高于临界值。ALT在7例患者中高于临界值，AST在20例中较高。高于临界值的AST和/或ALT水平发展的中位时间为4.0个月。两名患者的肝毒性转氨酶水平。3例患者转氨酶和SUA水平均升高。

结论 异烟肼除引起儿童转氨酶升高外，还可能引起高尿酸血症。