Journal of Yeungnam Medical Science

Case Reports

A Case of Rifampin-Induced Recurrent Adrenal Insufficiency During the Treatment of Pulmonary Tuberculosis in a Patient with Addison's Disease.: Jong Sik Kang, Gwang Beom Ko, Jae June Lee, Minsoo Kim, Sung Jin Jeon, Gwang Hyeon Choi, Sun Mok Kim, Woo Je Lee; Yeungnam Univ J Med. 2012;29(1):19-23. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.19

Abstract PDF: Adrenal insufficiency during the treatment of pulmonary tuberculosis is a troublesome condition and can at times be lifethreatening if untreated. Rifampin is one of the most widely prescribed anti-tuberculosis agents. Furthermore, rifampin has been known to be capable of affecting the metabolism of various medications, including glucocorticoids. In this paper, a case of recurrent adrenal insufficiency induced by rifampin during the treatment of pulmonary tuberculosis is reported. The patient was a 63-year-old man who was diagnosed with Addison's disease 17 years earlier and had been undergoing glucocorticoid replacement therapy. Five months before, the patient manifested pulmonary tuberculosis and was immediately given anti-tuberculosis medication that included rifampin. After one week of medication, general weakness and hyponatremia occurred. Despite the increased dose of the glucocorticoid medication, the adrenal insufficiency recurred many times. Since the substitution of levofloxacin for rifampin, the episodes of adrenal insufficiency have not recurred so far.

A case of Rifampin-induced Acute Renal Failure.: Dong Hwa Lee, Te Gue Park, Je Sung Lee, Heui Sik Kim, Kyoung Hyun Kim, Young Jun Ha, Sung Bok Jung, Jun Young Do, Kyung Woo Yoon; Yeungnam Univ J Med. 1998;15(1):173-181. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.173

Abstract PDF: Rifampin is common drug to treat tuberculosis. Rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia is rare and severe complication. We have experienced a case of rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia. Forty-six years old male was suffered from reactivation of pulmonary tuberculosis, and had to medicate antituberculosis drugs including rifampin(600mg/day). Seven years ago, antituberdulosis medication were successfully administered to treat pulmonary tuberculosis without any side effects of drugs. But eight days after readministration of rifampin, fever, abdominal pain, vomiting, oliguria, elevated BUN and creatinine were developed. And thrombocytopenia was also identified after administration of rifampin. The patient was recovered slowly after discontinuation of rifampin & intensive medical care. The renal function was normalized at 55 days after cessation of rifampin. The renal pathologic findings were interstitial nephritis and acute tubular necrosis. And, the rifampin dependent antibodies were identified by indirect antiglobulin test in the presence of rifampin. So we report this case with a brief review of literature.

Search