Meliha TAN, Özlem ALKAN, Sibel KARACA, Karakurum Başak GÖKSEL, Yusuf Ziya DEMİROĞLU

Cerebellitis due to antituberculosis therapy in a patient with chronic renal failure

Kronik böbrek yetmezlik nedeniyle diyalize giren olgularda tüberküloz insidansı normal popülasyona göre artmıştır. Ayrıca bu olgularda antitüberküloz ilaçların yan etkileri daha fazla görülür. Ototoksite ve toksik retinopati antitüberküloz ilaçların iyi bilinen yan etkileri olmasına rağmen, serebellar sendrom nadiren karşımıza çıkar. Biz bu sunumda, antitüberküloz tedavi sırasında serebellar ataksi gelişen ve kronik böbrek yetmezliği olan 50 yaşında kadın olgunun bulgularını tartıştık. Beyin manyetik rezonans görüntülenmesinde serebellar ödem saptandı. Antitüberküloz ilaç tedavisinin kesilmesi ve piridoksin tedavisinin başlamasıyla serebellar bulgularda kısmen düzelme izlendi. Bizim hastamızdaki serebellar bulgular olasılıkla izoniazid toksitesine sekonder gelişti. Sonuç olarak, izoniazid tedavisi alan diyalize giren olgularda serebellar bulgular geliştiğinde, izoniazid toksitesine bağlı serebellit tanısı akılda tutulmalıdır.

Kronik renal yetmezlikli bir olguda antitüberküloz tedaviye bağlı serebellit gelişimi

The incidence of tuberculosis in patients treated with hemodialysis for chronic renal failure is higher than in the general population. Further, those patients often experience adverse effects from therapy with anti-tuberculosis drugs. Although the ototoxicity and toxic retinopathy caused by antituberculosis drugs is well known, the cerebellar syndrome is rare. We presented a 50-year-old woman developed cerebellar ataxia who was on hemodialysis program and taking anti-tuberculosis drugs combination therapy. Brain magnetic resonance imaging showed cerebellar edema. Cerebellar signs partially reversed after discontinuation of anti-tuberculosis therapy and initiation of pyridoxine therapy. In our patient, isoniazid was probably the drug that caused cerebellar signs and symptoms. In conclusion, a diagnosis of isoniazid-induced cerebellitis should be considered when cerebellar signs develop in patients undergoing hemodialysis and treated with isoniazid.

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