rifampin and Carcinoma--Renal-Cell

Reactivation of tuberculosis is rare in patients receiving chemotherapy for solid tumours, and poorly documented in patients receiving molecular targeted therapy. We report on a patient with metastatic renal-cell carcinoma treated with temsirolimus, who developed respiratory symptoms and mild fever after 6 weeks of treatment. CT-scan and laboratory tests were consistent with reactivation of tuberculosis. The patient received anti-tuberculosis therapy including rifampicin, a potent CYP3A4/5 inducer. After introduction of rifampicin-based treatment, the patient experienced tumour progression, leaving questionable the potential pharmacokinetic interaction between rifampicin and temsirolimus, a substrate for CYP3A4.

Topics: Aged, 80 and over; Antibiotics, Antitubercular; Antineoplastic Agents; Carcinoma, Renal Cell; Cytochrome P-450 CYP3A; Drug Interactions; Enzyme Induction; Humans; Kidney Neoplasms; Male; Neoplasm Metastasis; Rifampin; Sirolimus; Tuberculosis

To describe a case of limbic encephalitis which initially presented as viral limbic encephalitis and during the clinical evaluation a renal carcinoma was diagnosed.. Patient with history of peripheral paresis of right facial nerve, 1 month after symptoms appearance and treatment, developed fever, vomiting, grand mal seizure, decreased level of consciousness, confusion, hallucinations and agitation. The patient initially presented a clinical picture of viral LE. which confirmed by CSF. MRI brain showed areas with pathological intensity signal in the region of limbic system unilateral. During the clinical evaluation a renal carcinoma was discovered and a nephrectomy has been performed.. Although PLE typically presents as a chronic or subacute disease, it may be fulminant and clinically indistinguishable from an acute HSVE. This association pose the problem of a possible relation between this two syndromes and the correct diagnosis is very important, because there are effective treatments.

Topics: Acute Disease; Acyclovir; Anti-Bacterial Agents; Anticonvulsants; Carcinoma, Renal Cell; Cerebrospinal Fluid; Diagnosis, Differential; Drug Therapy, Combination; Electroencephalography; Encephalitis, Viral; Enoxaparin; Ethambutol; Follow-Up Studies; Herpesvirus 1, Human; Humans; Isoniazid; Limbic Encephalitis; Limbic System; Magnetic Resonance Imaging; Male; Meningoencephalitis; Methylprednisolone; Middle Aged; Nephrectomy; Neuropsychological Tests; Paraneoplastic Syndromes, Nervous System; Phenytoin; Rifampin; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Vancomycin