[A case of sternoclavicular joint tuberculosis with renal failure due to rifampicin].
A 79-year-old man was admitted to a previous hospital complaining of left precordial swelling. Chest CT scan showed destruction of left sternoclavicular joint and a mass of 5 cm in diameter. Needle biopsy was performed and the diagnosis of sternoclavicular joint tuberculosis was made on the basis of presence of M. tuberculosis in the specimen. The patient was treated with isoniazid, ethambutol, rifampicin, and pyrazinamid but he developed renal failure. Then, he was transferred to our hospital. All medications were suspended because of the possibility of the side effect of drugs. We performed renal biopsy and histopathological examination revealed interstitial nephritis and minimal-change glomerulonephritis. From the result of examination, we considered interstitial nephritis was due to rifamicin. The treatment with 50 mg/day of prednisolone and isoniazid, ethambutol, and levofloxacin was administrated and renal failure and precordial mass were improved. Tuberculous arthritis usually affect hip and knee joint and sternoclavicular joint involvement is very rare.
Amano
Hiroyuki
H
Department of Pulmonary Medicine, Tokyo Metropolitan Fuchu Hospital, Tokyo, Japan. purapi71202000@yahoo.co.jp
Takamori
Mikio
M
Fujita
Akira
A
Sakashita
Kentarou
K
Murata
Kengo
K
Miyamoto
Maki
M
Wada
Akihiko
A
D000368:Aged; D006801:Humans; D008297:Male; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000150:complications; D012293:Rifampin / Q000009:adverse effects*; D013247:Sternoclavicular Joint; D014394:Tuberculosis, Osteoarticular / Q000150:complications* / Q000188:drug therapy
D012293:Rifampin