Tuberculosis (TB) is a condition brought by bacteria (Mycobacterium tuberculosis) that most often infects the lungs. About one-quarter of the world's population has been affected with TB infection, which means that they have been infected by TB bacteria but are not infected with the disease and cannot transmit it. Recent guidelines for anti-TB treatment has also recommended ways for managing the common adverse events like GI upset, rash, drug fever, hepatotoxicity and optic neuritis. However, there are no recommendations for the management of acute kidney injury. Incidence of hepatotoxicity resulting from ATT ranges from 2-28%. Rifampin, Isoniazid, Pyrazinamide and Ethambutol are the first line agents used for TB management. We report a case of a 45-year-old male with chief complaints of yellowish discoloration of eyes, urine, breathlessness and cough with sputum for a period of 1 week. He had a past medical history of Pulmonary Tuberculosis and was started on ATT regimen to which he developed jaundice and abnormality in LFT and RFT. Laboratory investigation confirmed the diagnosis as ATT induced Hepatitis and Nephropathy. Using Naranjo Scale, causality assessment was done and the result showed that the reaction occurred is possible. This condition might have been resulted from other co-morbidities (DM) and risk factors (chronic alcoholism) which was successfully managed by providing supportive care and symptomatic treatment.

Index Terms - Tuberculosis, ATT Regimen, Hepatitis, Nephropathy, Renal function test, Liver function test.