ABSTRACT

An overdose of isoniazid (INH) is potentially fatal and attempts at suicide are very rare in children. Three patients aged 14–17 years who were receiving INH for tuberculosis prophylaxis were admitted to the emergency department with generalised tonic-clonic seizures. There was metabolic acidosis and elevated levels of blood creatine kinase, aminotransferases and lactate dehydrogenase following ingestion of excess INH in attempts at suicide. The presumed total amounts of INH ingested were 3 g (40 mg/kg), 9 g (160 mg/kg) and 6 g (100 mg/kg), respectively. They all improved with general supportive measures including airway protection, gastric lavage, activated charcoal administration, sodium bicarbonate infusion, fluid replacement, seizure control and pyridoxine administration. They were discharged without complications. Attempts to commit suicide by excess intake of INH is rare in children but should be considered in the differential diagnosis of acute intractable seizures and metabolic acidosis refractory to conventional anticonvulsant therapy in adolescents.

摘要

过量服用异烟肼 (INH) 可能会致命，而且儿童的自杀企图非常罕见。三名年龄在 14-17 岁之间接受 INH 预防结核病的患者因全身性强直阵挛性癫痫被送往急诊室。在企图自杀时摄入过量的异烟肼后，出现代谢性酸中毒和血肌酸激酶、氨基转移酶和乳酸脱氢酶水平升高。摄入的异烟肼总量分别为 3 g (40 mg/kg)、9 g (160 mg/kg) 和 6 g (100 mg/kg)。通过一般支持措施，包括气道保护、洗胃、活性炭给药、碳酸氢钠输注、补液、癫痫控制和吡哆醇给药，他们都得到了改善。他们出院时没有并发症。