Open AccessÜBER DIE TOXISCHE WIRKUNG VON ANTITUBERKULOSE‐MEDIKAMENTEN, BESONDERS ETHAMBUTOL UND INH, AUF DAS NERVENSYSTEM: EIN AUTOPSIE‐BERICHT
Author(s) -
Kuribayashi Nobuo,
Utsumi Kunisuke,
Oda Masaya,
Shiraki Hirotsugu
Publication year - 1972
Publication title -
acta patholigica japonica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
ISSN - 0001-6632
DOI - 10.1111/j.1440-1827.1972.tb00748.x
Subject(s) - medicine , ethambutol , pathology , autopsy , optic neuritis , optic nerve , tuberculosis , dermatology , rifampicin , anatomy , multiple sclerosis , immunology
A 31‐year old tuberculous male patient, who was initially treated by combined anti‐tuberculous drugs (SM, PAS & INH) for 9 months and later by Ethambutol (Ebutol) instead of SM for 6.5 months in the intermediate period of his course until occurrence of visual disturbance, died in a uremic state at which time only PAS and INH had been given. Autopsy revealed advanced flbro‐caseous tuberculosis of bilateral lungs, severe cavernous phthisis of both kidneys with ancient affections of the urogential organs and diffuse enterocolitis. The central nervous system disclosed an evident degeneration with marked astrocytosis in the optic nerve and Goll's tract of the spinal cord. The nerve cells of the retinal ganglionic‐cell layer were also impaired and decreased in number chiefly around the papillary regions. It was pointed out and stressed that a given common‐dosage of anti‐tuberculous drugs, particularly of Ethambutol and INH, may produce a toxic effect and lesions in the nervous system, when administered to such a malnourished patient who has advanced renal failure and intestinal dyscrasia as in this case.