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World Journal of Pharmaceutical
and Medical Research

An International Peer Reviewed Journal for Pharmaceutical and Medical Research and Technology
An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)
ISSN 2455-3301
IMPACT FACTOR: 5.922

ICV : 78.6

Abstract

SLOW ACCOUTUMANCE PROTOCOL FOR ANTITUBERCULOSIS DRUGS DELAYED HYPERSENSITIVITY REACTION IN CHILDREN: ABOUT ONE CASE

N. Aarbaoui, F. Benbrahim, S. Benchekroun, Chafik Mahraoui and Dr. Naima EL Hafidi*

ABSTRACT

Introduction: Antituberculosis drugs hypersensitivity reactions remains an unpredictable side effect, this occurrence may deprive patients of drug therapy, which subsequently need to be reinitiated as no better alternatives exist. Case report: We report a case of a seven years old boy, who was diagnosed with two tuberculosis localizations: caseous pneumonia and mediastinal lymphadenopathy. An associated HIV infection was ruled out and was started on a drug combination regimen of isoniazid, rifampicin, ethambutol, and pyrazinamide. After 20 days of therapy he developed a pruritus and generalized maculopapular exanthema, with fever, the blood test was normal. We considred this presentation as a drug toxidermia. The antituberculosis therapy was stoped, and we prescribed antihistaminic treatement. Three days later, the rash has completely disappeared and we achieved apyrexia. An accoutumance protocol of antituberculosis drugs was started, we followed a slow protocol on 21 days. The time intervals between dose escalations of each drug were 24 hours. Subsequent drugs were sequentially added three days later when the preceding drug was tolerated. The tuberculosis treatment has been completed for six months by drug combination regimen, without any side effects, with improvement of clinical and radiologycal condition. Conclusion: Slow accoutumance in our patient is considered as an approach to the management of antituberculosis delayed hypersentivity reactions. The literature lacks reported cases on antituberculosis drug accoutumance in children. The availability of validated protocols is crucial for the success of this procedure.

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