Krishnamurthy, D V and Selkon, J B and Ramachandran, K and Devadatta, S and Mitchison, D A and Radhakrishna, S and Stott, H
(1967)
Effect of Pyridoxine on Vitamin B6 Concentrations
and Glutamic-Oxaloacetic Transaminase Activity
in Whole Blood of Tuberculous Patients Receiving
High-Dosage Isoniazid.
Bulletin of the World Health Organization, 36 (5).
pp. 853-870.
ISSN 00429686
Abstract
An earlier report from the Tuberculosis Chemotherapy Centre, Madras, showed that,
in tuberculous patients receiving high-dosage isoniazid (12.5-15.6 mg/kg body-weight),
the concomitant administration of 6 mg of pyridoxine prevented peripheral neuropathy.
In that study, biochemical determinations of B6 concentrations and GOT activity in whole
blood had been routinely undertaken on all patients on admission to treatment, and at 6,
12, 24 and 52 weeks thereafter; in addition, extra determinations were undertaken for
patients who developed peripheral neuropathy. The present paper reports the findings of
these investigations, which are: (a) peripheral neuropathy developed predominantly among
slow inactivators of isoniazid, and was associated with a substantial reduction in GOT
activity but no apparent change in B6 concentration; (b) the reduction in GOT activity
appeared to be due to deficiency of both the coenzyme (pyridoxal phosphate) and the
apoenzyme; (c) the concomitant administration of pyridoxine (6 mg or 48 mg) with
high-dosage isoniazid to 3 patients with peripheral neuropathy, 1 of whom had convulsions
also, resulted in increased B6 concentrations and GOT activity, and no further convulsions;
and(d) the concomitant administration of pyridoxine 6 mg daily, as a prophylactic, resulted
in a significant increase in B6 concentrations and GOT activity and prevention of the
neuropathy.
These findings establish the existence of a definite association between the occurrence
of isoniazid-induced toxicity and diminished pyridoxine function.
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