LAUSR

I read with interest the paper on Isoniazid induced cerebellitis by Shah VS and Sardana V in the recent AIAN journal.[1] The authors described a patient with chronic renal disease, on 375 mg of isoniazid without pyridoxine supplements, who developed cerebellar toxicity. His MRI showed classical dentate signal changes and he made clinical and radiological recovery following withdrawal of isoniazid and addition of pyridoxine. Certainly, the paper is an important reminder for clinicians to be cautious of this complication in renal disease. However, two statements in the discussion section could confuse the clinicians on the appropriate dose of isoniazid in renal disease. The authors initially, and rightly, state that no dose modification of isoniazid is needed in renal disease. But, in the concluding remarks, they infer from this particular case that a dose modification of ‘anti tubercular drugs’ is indeed needed.