title: [Severe complications following intermittent administration of rifampicin].
abstract: In the last two years the authors have noted the cases of five patients with pulmonary tuberculosis to which intermittent treatment with Rifampicin was administered (twice weekly, 600-900 mg/day), in association with Ethambutol. Between 2 and 6 months after the treatment was started, 24-72 hours after the last administration of Rifampicin acute renal failure developed in all five cases. Two of the patients also had signs of liver failure (increased serum transaminase, lowered pseudo-cholinesterase, increased BSP retention), and in one of them there was also a hematological syndrome consisting in hemolytic anemia and thrombocytopenia. Four of the patients benefited from application of diuretics, hydroelectrolytic re-equilibration and/or hemodialysis. One of the subjects died 12 hours after being hospitalized, with acute pulmonary oedema, refractory to treatment. From the histopathological viewpoint glomerular lesions were found in the kidney (non-uniform thickening of the basal membranes by PAS-positive deposits). In two of the patients various immunological tests have been carried out (Coombs test, lymphocyte-migration inhibition, serum and urine immunelectrophoresis) that, by their alterations, provide some elements indicating the immunological origin of the phenomena.
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000328:Adult; D000368:Aged; D000743:Anemia, Hemolytic / Q000139:chemically induced*; D056486:Chemical and Drug Induced Liver Injury; D006801:Humans; D011654:Pulmonary Edema / Q000139:chemically induced*; D012293:Rifampin / Q000009:adverse effects* / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000139:chemically induced*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
chemical_list: D012293:Rifampin
vernacular_title: Accidente grave consecutive administrării intermitente de rifampicină