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[Clinico-pathological features and possible pathogenesis of rifampicin-induced acute renal failure]
1Renal Division, Department of Medicine, The First Hospital, Peking University Health Science Center, Beijing 100034, China.
Objective:
To explore the clinico-pathological features and possible pathogenesis of rifampicin-associated acute renal failure (ARF).
Methods:
The clinico-pathological features of 4 patients with Rifampicin-associated ARF were analyzed. Rifampicin-dependent antibody in the patient's serum was detected with Coomb's test.
Results:
4 cases with rifampicin-associated ARF was distinguished from 202 in-patients with ARF in 5 years(1.98%). Most of them had infection before the occurrence of ARF. Clinical features were characterized by fever, fatigue and gastro-intestinal symptoms after taking rifampicin (especially when it was reused). Oliguria or anuria developed suddenly. Laboratory data showed hemolytic anemia, thrombocytopenia and decline of renal function. Some also had impaired liver function. Renal biopsy revealed acute tubular necrosis in 3 cases and acute interstitial nephritis in 1 case. Serum rifampicin-dependent antibody was positive in all the cases.
Conclusion:
Rifampicin-associated ARF is not rare clinically, especially in those rifampicin re-exposure patients. Renal function should be closely monitored in susceptible patients. Detection of serum rifampicin-dependent antibody may be helpful to distinguish this group of ARF patients.