Acute renal failure by intermittent rifampin administration in leprosy patient / 대한내과학회지

ABSTRACT

A 74-years-old female with leprosy was hospitalized because of nausea, vomiting, and oliguria after ingestion of rifampin 600 mg once for one day. At this time, after taking the second dose of rifampin, she presented with anemia, hepatic dysfunction and oliguric renal failure. Renal biopsy specimen showed acute interstitial nephritis and tubular necrosis without immunoglobulin deposition on immunofluorescence examination. Peripheral blood smear showed fragmented red blood cells (RBCs) and direct Coombs' test was positive. Indirect antiglobulin test with patient's serum using RBCs sensitized in vitro with rifampin showed positive finding. The renal failure and systemic symptoms were improved after discontinuation of rifampin, high dose prednisolone administration and several sessions of hemodialysis.