Hyperuricemia & Arthralgia during Pyrazinamide therapy in patients with Pulmonary Tuberculosis.

Authors

  • Naveed Inayat
  • Riaz Hussain Shah
  • Manzoor Ali Lakhair
  • Rubina Sahito

Keywords:

Tuberculosis, Uric acid, Pyrazinamide, Hyperuricemia, Arthralgia

Abstract

Objective:  To assess the effect of Pyrazinamide induced Hyperuricemia in patients with Pulmonary Tuberculosis.Design: Prospective study case control studyPlace and duration: Liaquat University Hospital Jamshoro, during the period of one year fromJanuary 2014 to December 2014.Material and Methods:  Patients were selected from chest out-patient department and chest ward. Pulmonary Tuberculosis was diagnosed on the basis of history, clinical examination, chest radiography, sputum examination for Acid Fast Bacilli, pleural fluid D/R, and PCR. Patients were admitted in pulmonology ward for eight weeks. All patients underwent combination therapy with Rifampicin, isoniazid, ethambutol and pyrazinamide for eight weeks. All patients were evaluated for arthralgia based on self-reported signs and symptoms.The details of demographic data, clinical characteristic, chemotherapy, adverse reaction to drugs and follow-up assessment as well as regular sputum bacteriology and serum uric acid levels were monitored at 0, 2, 6 and 8 week. Pyrazinamide was discontinued after 8 weeks of therapy.Result:  The serum uric acid estimation was done in a total of 46 patients, who have received Pyrazinamide for duration of 8 weeks. Our results indicated that 43%of patients showed hyperuricemia and 21.7% showed Arthralgia. The mean uric acid level was significantly higher at 2, (6.8mg/ml), 6 (7.2mg/dl), and 7 week (7.4mg//dl) as compared to zero week (5.1mg/dl). An overall 75%, 71%and69%total increase was observed respectively over time.Conclusion:  This study concluded that anti-tuberculosis drug therapy with Pyrazinamide affect the uric acid levels, resulting in significant hyperuricemia with some arthralgia. This change was found to be spontaneously reversible or with Aspirin therapy.

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Published

2017-04-21

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Original Article