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Rifampicin-induced porphyria cutanea tarda
British Journal of Diseases of the Chest
|October 1, 1980
Summary
Rifampicin, used for tuberculosis, can cause porphyria cutanea tarda and liver issues. This case highlights the need for careful liver function monitoring during treatment, especially in patients with a history of this condition.
Area of Science:
- Hepatology
- Pharmacology
- Dermatology
Background:
- Tuberculosis treatment often involves combination chemotherapy.
- Rifampicin and isoniazid are common first-line anti-tuberculosis drugs.
- Liver function monitoring is standard during tuberculosis treatment.
Observation:
- A patient developed porphyria cutanea tarda and abnormal liver function tests after starting rifampicin and isoniazid for a tuberculous psoas abscess.
- The patient had normal liver function before treatment and was found to have cholelithiasis.
- Challenge testing identified rifampicin as the likely cause of porphyria cutanea tarda and liver function disturbances, particularly elevated serum bilirubin.
Findings:
- This report describes a novel association between rifampicin use and the precipitation of porphyria cutanea tarda.
- Rifampicin is known to induce liver enzyme systems, including delta-aminolevulinic acid synthetase, which is implicated in porphyria.
- The findings suggest rifampicin-induced hepatotoxicity can manifest as porphyria cutanea tarda.
Implications:
- This case underscores the importance of vigilant liver function monitoring in patients receiving rifampicin.
- Rifampicin should be administered with caution to individuals with a prior history of porphyria cutanea tarda.
- Further research may elucidate the precise mechanisms of rifampicin-induced porphyria cutanea tarda.