Rifampicin-induced immune haemolytic anaemia in a patient on daily anti-tuberculosis treatment

ABSTRACT

Report one case of a 45 years old male patient lived in Hoc Mon district, Ho Chi Minh City, and admitted in November 24th 2004. His tuberculosis (TB) was first diagnosed in the year 2000 and he was received anti-TB drugs with 2SHR/6HE regime at the anti-TB station. During hospitalization, after 10 days of SHRZE regime (SM 1/2g, Rif 300mg PO, INH 200mg PO, PZA 750mg PO, EMB 600mg PO), he experienced fatigue, dyspnea, jaundice, fever of 39 degree C, blood pressure 8/5cmHg, SpO2 = 90%. Hematological analysis revealed low hemoglobin and Hct levels, and increase of reticulocyte count and white blood cell count; a positive direct Coombs test. Biochemical tests revealed elevated total, direct and indirect bilirubin levels, increased LDH; decreased haptoglobin; LE cell and ANA were all negative. Patient was diagnosed immune haemolytic anemia and was treated by blood transfusion with the same blood group. He discharged at December 17th 2004 with the last diagnosis was recurrent tuberculosis M(+), rifampicin-induced immune haemolytic anemia