rifampin and Glomerulonephritis

Topics: Animals; Anti-Glomerular Basement Membrane Disease; Anti-Inflammatory Agents; Antibodies; Captopril; Drug Hypersensitivity; Environmental Exposure; Glomerulonephritis; Gold; Heroin; Humans; Hydrocarbons; Hypersensitivity, Delayed; Hypersensitivity, Immediate; Immune Complex Diseases; Kidney Diseases; Kidney Glomerulus; Lupus Erythematosus, Systemic; Mercury; Nephritis, Interstitial; Penicillamine; Penicillins; Rifampin

Topics: Allopurinol; Aminoglycosides; Analgesics; Anti-Bacterial Agents; Anti-Inflammatory Agents; Captopril; Cephalosporins; Cisplatin; Diuretics; Glomerulonephritis; Gold; Humans; Kidney; Kidney Diseases; Kidney Tubular Necrosis, Acute; Lithium; Nephritis, Interstitial; Penicillamine; Penicillins; Rifampin; Semustine; Sulfonamides; Tetracycline; Trimethadione

(1) AIN is the most frequent pattern of drug-induced immunologically mediated renal injury. A number of drugs may be responsible for AIN, namely methicillin and other penicillin derivatives, rifampicin, phenindione and sulfonamides. Particular clinical and pathological features often suggest an immune pathogenetic mechanism. IgG anti-TBM and IgE antibodies have been found in only a few cases and it is likely that antibody-mediated and cell-mediated injury may operate in the same patient. (2) Only few examples of drug-induced vasculitis and glomerulonephritis are known, and the pathophysiology of this kind of renal damage is poorly understood.

Topics: Acute Kidney Injury; Antigens; Basement Membrane; Drug Hypersensitivity; Glafenine; Glomerulonephritis; Humans; Kidney; Kidney Glomerulus; Kidney Tubules; Methicillin; Nephritis, Interstitial; Penicillin G; Penicillins; Phenindione; Rifampin; Sulfonamides; Vasculitis

A 73-year-old man presented with acute renal failure after 3-month standard antituberculosis therapy with rifampicin for pulmonary tuberculosis. Previously undiagnosed human immunodeficiency virus (HIV) infection was found at the same time. A kidney biopsy showed crescentic glomerulonephritis and tubulointerstitial nephritis. Furthermore, endothelial tubuloreticular inclusions were seen on electron microscopy. Rifampicin was stopped because it was considered as the most possible cause responsible for the rapidly progressive glomerulonephritis (RPGN). Immunosuppressive therapy was not carried out because of the risk of aggravation of underlying infectious diseases including tuberculosis and HIV. Fortunately, renal function recovered 1 month after discontinuation of rifampicin. This case presented a clinical challenge in the differential diagnosis of the cause for RPGN in such a complex condition and the therapeutic dilemma regarding the use of immunosuppressive drugs.

Topics: Aged; Antibiotics, Antitubercular; Glomerulonephritis; HIV Infections; Humans; Male; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Antibiotics, Antitubercular; Biomarkers; Female; Glomerulonephritis; Humans; Immunoenzyme Techniques; Kidney Glomerulus; Rifampin; T-Lymphocytes; Tuberculosis, Pulmonary

A 60-year-old man was treated with rifampicin, isoniazid, ethambutol and pyrazinamide for pulmonary tuberculosis. Acute renal failure developed 1 month after re-administration of rifampicin following 1 month's interruption of treatment. A renal biopsy showed crescentic lesions characteristic of rapidly progressive glomerulonephritis. This is, to our knowledge, the fourth case of rapidly progressive crescentic glomerulonephritis associated with rifampicin treatment, which responded to methylprednisolone pulse therapy followed by oral steroid therapy.

Topics: Antibiotics, Antitubercular; Disease Progression; Glomerulonephritis; Humans; Male; Middle Aged; Rifampin

A 64-year-old male was treated continuously with rifampin, isoniazid and streptomycin for pulmonary atypical mycobacteriosis, Mycobacterium kansasii. Five weeks after beginning the treatment, the patient suddenly developed acute renal failure. A renal biopsy showed crescentic lesions characteristic of rapidly progressive glomerulonephritis with moderate interstitial changes. Serum antirifampin antibody was detected, and the cessation of rifampin treatment was followed by a rapid spontaneous recovery of the patient's renal function. This is, to our knowledge, the first case of rapidly progressive crescentic glomerulonephritis associated with rifampin treatment where circulating antirifampin antibody is demonstrated and the renal function spontaneously improved after discontinuing rifampin treatment.

Topics: Antibiotics, Antitubercular; Drug Therapy, Combination; Glomerulonephritis; Humans; Isoniazid; Leprostatic Agents; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Rifampin; Streptomycin; Tuberculosis, Pulmonary

This case study reveals an unusual finding of rapidly proliferative crescentic glomerulonephritis in a patient treated with rifampin who had no other identifiable causes for developing this disease. This patient underwent a 10-month regimen of rifampin and isoniazid for pulmonary tuberculosis and was discovered to have developed signs of severe renal failure five weeks after completion of therapy. Renal biopsy revealed severe glomerulonephritis with crescents, electron dense fibrillar deposits and moderate lymphocytic interstitial infiltrate. Other possible causes of rapidly progressive glomerulonephritis were investigated and ruled out. This report documents the unusual occurrence of rapidly progressive glomerulonephritis with crescents and fibrillar glomerulonephritis in a patient treated with rifampin.

Topics: Acute Kidney Injury; Adult; Biopsy; Drug Therapy, Combination; Glomerulonephritis; Humans; Isoniazid; Kidney Glomerulus; Male; Microscopy, Electron; Rifampin; Tuberculosis, Miliary; Tuberculosis, Pulmonary

Topics: Adult; Female; Glomerulonephritis; Humans; Rifampin; Skin Diseases, Vascular; Vasculitis

Topics: Adult; Cryoglobulinemia; Drug Therapy, Combination; Glomerulonephritis; Humans; Immune Complex Diseases; Isoniazid; Male; Rifampin; Tuberculosis, Pulmonary

Two months after commencing continuous treatment with rifampicin, isoniazid, streptomycin and pyrazinamide for pulmonary tuberculosis a patient developed a nephrotic syndrome, acute nonoliguric renal failure and evidence of intravascular hemolysis. Renal biopsy revealed a severe crescentic nephritis with mild interstitial changes. The use of rifampicin has been associated with various renal abnormalities and this report documents the occurrence of a rapidly progressive crescentic glomerulonephritis presenting as nephrotic syndrome in a patient receiving continuous treatment with rifampicin.

Topics: Acute Disease; Acute Kidney Injury; Adult; Glomerulonephritis; Humans; Kidney Glomerulus; Male; Nephrotic Syndrome; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Brucellosis; Doxycycline; Drug Therapy, Combination; Glomerular Mesangium; Glomerulonephritis; Humans; Immunoglobulin A; Male; Rifampin

In a patient with tuberculosis and acute renal failure related to administration of therapeutic rifampin, treatment was discontinued for five weeks. It was reinstituted three weeks later. Unlike other patients previously described, the expected adverse renal reaction occurred only gradually and without symptoms, although tubular and glomerular disease developed. Also unique was a striking deposition of immunoglobulin about the tubules. This finding, in association with interstitial nephritis and tubular glycosuria, is similar to an experimental autologous renal disease mediated by antibody to tubular basement membrane.

Topics: Acute Kidney Injury; Autoantibodies; Basement Membrane; Complement C3; Creatinine; Fibrinogen; Glomerulonephritis; Glycosuria; Humans; Immunoglobulin A; Immunoglobulin G; Kidney Tubules; Male; Methods; Middle Aged; Nephritis, Interstitial; Rifampin; Time Factors; Tuberculosis, Pulmonary

Drug-induced hypersensitivity nephritis may show several histological and clinical patterns. In most of these microscopic vascular involvement of the kidney seems to be very frequent. On immunofluorescence, deposits of C3 in mesangium and in arterioles were observed in almost all cases, independently of histological features on light microscopy. The pointing out of clinico-histological relationship seems to be the best rational approach to diagnosis of these conditions.

Topics: Adult; Aged; Ampicillin; Complement C3; Complement C4; Drug Hypersensitivity; Female; Fluorescent Antibody Technique; Glomerulonephritis; Humans; Immunoglobulin G; Immunoglobulin M; Kidney Glomerulus; Male; Methicillin; Middle Aged; Nephritis; Nephritis, Interstitial; Rifampin

A patient with hydrocephalus and a ventriculojugular shunt presented with acute nephritis, nephrotic syndrome (proteinuria 10 g/24 hours), decreased complement levels, circulating immune complexes and diminished creatinine clearance (41 ml/min). Seven blood cultures grew Corynebacterium bovis. A renal biopsy specimen revealed mesangiocapillary glomerulonephritis by light microscopy, and thickened glomerular basement membranes with areas of increased granular density by electron microscopy. Immunofluorescent examination of the biopsy specimen demonstrated 2+ granular glomerular basement membrane deposits of immunoglobulin M (IgM), with trace third component of complement (C-3), fourth component of complement (C-4) and immunoglobulin G (IgG). Rabbits immunized with C. bovis produced a line of partial identity in agar with patient serum against a sonicate of C. bovis. Indirect fluorescein staining of the biopsy specimen with the rabbit antiserum demonstrated 1+ granular glomerular basement membrane deposits. Potassium thiocyanate microelution of sections prior to examination markedly diminished staining with antihuman antiserum, but did not affect staining with rabbit antiserum. Following initial therapy with intravenous penicillin for six weeks the bacteremia cleared, serum complement levels returned to normal, proteinuria decreased and creatinine clearance increased. A relapse occured four weeks later with decreased complement levels, increased proteinuria and decreased creatinine clearance. Blood cultures were again positive for C. bovis. Following therapy with erythromycin and rifampin, the bacteremia cleared and there was a sustained improvement of all parameters. To our knowledge, this is the first time an association has been noted between C. bovis ventriculojugular shunt infection and glomerulonephritis. These findings support the potential role of C. bovis as an etiologic agent in human renal disease and further define the immune complex nature of shunt nephritis.

Topics: Adult; Animals; Biopsy; Cerebrospinal Fluid Shunts; Complement C3; Complement C4; Corynebacterium Infections; Erythromycin; Glomerulonephritis; Humans; Immunoglobulin G; Immunoglobulin M; Kidney; Male; Microbial Sensitivity Tests; Penicillins; Postoperative Complications; Rabbits; Recurrence; Rifampin

Topics: Acute Kidney Injury; Amebiasis; Antimalarials; Cholera; Drug Resistance, Microbial; Encephalitis; Glomerulonephritis; Helminthiasis; Hepatitis B Antigens; Humans; Leprosy; Malaria; Neurologic Manifestations; Parasitic Diseases; Pyrimethamine; Rifampin; Sulfonamides; Thiabendazole; Tropical Medicine; Trypanosomiasis, African