Mesothelioma in Child with Prenatal Exposure to Isoniazid

Our plain-English summary of Mesothelioma in Child with Prenatal Exposure to Isoniazid, by K.J. Luman, R.R. Chilcote, R.I. Berkow, et al (1980).

The study

• Authors: K.J. Luman, R.R. Chilcote, R.I. Berkow, J.W. Moohr
• Published: Lancet, August 16th 1980
• Type of article: Letter
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This letter to The Lancet was a case report about one child. The authors described a 9-year-old boy admitted in 1978 with pain in the left front of his chest, loss of appetite and weight loss. His mother had had a positive tuberculin skin test early in pregnancy and was treated with the tuberculosis drug isoniazid during the second and third trimesters. The authors reported that no one in the household had been exposed to asbestos. Fluid drawn from the chest showed no cancer cells. Surgery found thickened pleura with small grey-white nodules on the lung, pericardium and diaphragm, and a biopsy showed malignant mesothelioma. He received chemotherapy every 4 weeks. The tumour did not grow on chest X-rays, but a chest wall deformity severely restricted his breathing. He died at home after a respiratory infection 17 months after diagnosis, and no autopsy was permitted. The authors concluded that further studies with longer follow-up are needed before one can conclude that isoniazid is not a carcinogen in humans.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (letter to the editor)
• Who was studied: one 9-year-old boy, admitted in 1978, reported by the Department of Pediatric Hematology/Oncology, University of Chicago
• Exposure: prenatal exposure to isoniazid: the mother had a positive tuberculin skin test early in pregnancy and was treated with isoniazid in the second and third trimesters. The authors reported no known asbestos exposure in the household and no occupational asbestos history in either parent.
• Main results:
  • The household had no reported asbestos exposure and neither parent had an occupational history of asbestos exposure
  • Cytological examination of the pleural fluid found no malignant cells
  • At thoracotomy, multiple small nodular grey-white plaques were found studding the lung, pericardium and hemidiaphragm. Biopsy of these tissues showed malignant mesothelioma.
  • He was treated with cyclophosphamide, doxorubicin, dacarbazine and vincristine, repeated every 4 weeks
  • The tumour did not progress on chest radiographs, but the chest wall deformity severely restricted lung function
  • He developed a respiratory infection 17 months after diagnosis and died at home. Necropsy was not permitted.
• The authors' conclusion: The authors concluded that further studies with longer follow-up are necessary before one can conclude that isoniazid is not a carcinogen in humans.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleura, Pericardium, Diaphragm, Biopsy, Chemotherapy, Chest X-Ray, Autopsy.

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