IgG-mediated intravascular hemolysis and nonoliguric acute renal failure complicating discontinuous rifampicin administration.
Acute renal failure following intermittent or discontinuous rifampicin therapy is a relatively infrequent clinical observation. Many pathogenetic mechanisms for the renal failure have been proposed, including intravascular hemolysis with hemoglobinuria and its consequent nephrotoxicity. We report the case of a patient who used rifampicin in a discontinuous fashion and developed hemolysis with nonoliguric acute renal failure. Most reported cases of antirifampicin antibodies are of the IgM class; thus, the development of an IgG antirifampicin antibody is of interest, especially because of its strong in vivo hemolytic properties. In addition, this patient developed a nonoliguric uremic course that did not require dialysis, both of which are distinctly unusual for this clinical setting.
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000276:immunology; D006461:Hemolysis / Q000187:drug effects*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D012293:Rifampin / Q000008:administration & dosage / Q000009:adverse effects*
D007074:Immunoglobulin G; D012293:Rifampin