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Case report
Mania induced by isoniazid preventive therapy during steroid treatment for rheumatoid arthritis and organising pneumonia
  1. Hiroyuki Nagano1,
  2. Tomoaki Miura2 and
  3. Takeshi Ueda1
  1. 1 Emergency Medicine and General Internal Medicine, Rakuwakai Marutamachi Hospital, Kyoto, Japan
  2. 2 Department of Nephrology, Kyoto Okamoto Memorial Hospital, Kuze-gun, Japan
  1. Correspondence to Dr Takeshi Ueda; maruta-GIM_ER-ueda{at}


Isoniazid preventative therapy is widely used for latent tuberculosis infection. Isoniazid is highly effective but has many adverse effects, including neuropsychiatric. We describe the case of an 80-year-old woman with mania. She had received isoniazid preventative therapy during steroid treatment for rheumatoid arthritis and organising pneumonia for the previous 5 months. Her mania resolved after discontinuation of isoniazid. Adverse effects of isoniazid should be considered even if a long time has elapsed since the start of administration. Physicians other than infectious disease and respiratory specialists also must be aware of the adverse effects of isoniazid preventative therapy.

  • TB and other respiratory infections
  • unwanted effects/adverse reactions

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  • Contributors HN contributed to this paper by acquiring results and writing this case report. TM contributed by discussing the template. TU assisted in providing the idea for the case report, doing final edits and overlooking the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.