rifampin and Nephritis--Interstitial

Can therapy with clindamycin and rifampicin be safely continued long term beyond the recommended 10-week course?. Clindamycin and rifampicin are used in combination to treat hidradenitis suppurativa (HS). There is no data on the efficacy and safety of clindamycin/rifampicin combination therapy for HS beyond 10 weeks.. We identified the following major concerns that still lack a proper evidenced-based analysis: for rifampicin, drug-induced liver injury, interstitial nephritis, drug interaction and hepatic p450 3A4 enzyme induction; for clindamycin, the concern was community-acquired Clostridium difficile infection (CA-CDI); and experience with long-term treatment. Data sources were used as appropriate to answer the question. Systematic searches were used to assess the risk of CA-CDI and experience with long-term treatment with clindamycin.. The risk for rifampicin-induced liver injury is highest in the first 6 weeks of treatment, whereas interstitial nephritis is primarily observed during intermittent treatment. Enzyme induction due to rifampicin is usually complete after about 2 weeks of treatment and reduces clindamycin blood levels by about 90%. Three meta-analyses identified antibiotic use as a risk factor for CA-CDI. Two of them assigned the highest risk to clindamycin. None of them stratified by length of treatment. There is extensive experience with rifampicin, primarily for the treatment of tuberculosis. Long-term experience with clindamycin is limited.. The analysed risks associated with a combination of clindamycin and rifampicin for hidradenitis suppurative cluster within the first 10 weeks. Treatment can be continued beyond 10 weeks, if clinically necessary.

Topics: Anti-Bacterial Agents; Chemical and Drug Induced Liver Injury; Clindamycin; Cytochrome P-450 CYP3A; Cytochrome P-450 CYP3A Inducers; Drug Interactions; Drug Therapy, Combination; Enterocolitis, Pseudomembranous; Hidradenitis Suppurativa; Humans; Meta-Analysis as Topic; Nephritis, Interstitial; Rifampin; Risk Assessment; Systematic Reviews as Topic; Time Factors

A 47-year-old man diagnosed with pulmonary tuberculosis was referred to our hospital. Rifampicin, isoniazid, pyrazinamide and ethambutol were administered, and the patient's symptoms promptly improved. On the 19th hospital day, he developed acute kidney injury with a fever and chills. Renal biopsy specimens indicated tubulointerstitial nephritis. Suspecting rifampicin-induced acute kidney injury, we discontinued the rifampicin and administered levofloxacin in its place. The patient's serum creatinine level subsequently gradually improved. We herein report this case and review eight cases reported in Japan. We found that the rifampicin toxicity appeared at both the initial administration and readministration. All eight patients presented with proteinuria.

Topics: Acute Kidney Injury; Antitubercular Agents; Creatinine; Drug Therapy, Combination; Humans; Japan; Male; Middle Aged; Nephritis, Interstitial; Rifampin; Tuberculosis, Pulmonary

A case of Legionella pneumophila pneumonia with rhabdomyolysis-induced acute tubulointerstitial nephritis (ATIN) and prolonged renal dysfunction is presented. The patient was a 54-year-old man, admitted with high-grade fever, ataxia and muscle dysfunction; chest roentgenogram showed multilobular infiltrations. L pneumophila was detected in his sputum and urine, by PCR and by culture, and L pneumophila pneumonia was diagnosed. Despite antimicrobial treatment, he developed renal failure and rhabdomyolysis. Renal biopsy showed the presence of myoglobin casts that occluded the distal tubuli and tubulointerstitial nephritis, leading to the diagnosis of rhabdomyolysis-induced ATIN. Renal function subsequently normalised, and he was discharged. This is believed to be the first pathological evidence of involvement of rhabdomyolysis in legionellosis-associated ATIN.

Topics: Anti-Bacterial Agents; Azithromycin; Ciprofloxacin; Humans; Kidney; Legionella pneumophila; Legionnaires' Disease; Male; Middle Aged; Nephritis, Interstitial; Rhabdomyolysis; Rifampin

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

Objective The standard anti-tuberculosis (TB) regimen occasionally causes acute kidney injury (AKI). The major etiology is rifampicin-induced acute interstitial nephritis. However, the standard management of AKI induced by anti-TB drugs has yet to be established. Methods We retrospectively reviewed patients with TB who developed AKI after starting standard anti-TB treatment between 2006 and 2016 at a single TB center. The clinical characteristics and the management are described. Results Among 1,430 patients with active TB, 15 (1.01%) developed AKI. The mean age (standard deviation) was 61 years (18). The median (interquartile range) time to AKI development was 45 days (21-54 days). The median serum creatinine level before anti-TB treatment was 0.7 mg/dL (0.5-1.4 mg/dL), whereas the median peak serum creatinine level after AKI onset was 4.0 mg/dL (3.08-5.12 mg/dL). Five patients (33.3%) were pathologically confirmed as having acute interstitial nephritis (AIN), and 7 patients (46.7%) had a clinical diagnosis of the disease. All anti-TB drugs were stopped, and steroids were administered to 5 (100%) patients with pathologically confirmed AIN and 3 (42.8%) patients with clinically diagnosed AIN. The renal function was normalized in 12 patients (80.0%) after restarting anti-TB treatment without rifampicin (n=12) or isoniazid (n=1). Two patients died due to severe renal failure after restarting rifampicin. Conclusion Rifampicin is the leading cause of AKI. Levofloxacin may be an alternative to rifampicin thanks to its safety and potency. Restarting anti-TB treatment without rifampicin and short-term steroid administration may be a feasible management for AKI.

Topics: Acute Kidney Injury; Adult; Aged; Aged, 80 and over; Antitubercular Agents; Female; Humans; Japan; Male; Middle Aged; Nephritis, Interstitial; Retrospective Studies; Rifampin; Tuberculosis

There are many side effects of antituberculous drugs, however, renal failure is relatively rare. Therefore, this side effect is thought to be unrecognized by most physicians. We experienced one case of acute renal failure caused by antituberculous therapy (rifampicin).. A 64-year-old Japanese male developed tuberculous pleuritis. Six weeks after starting isoniazid (INH), rifampicin (RFP), and ethambutol (EB), his renal function worsened. We temporarily stopped antituberculous therapy, but the patient's renal failure did not improve, and he was admitted to our hospital for renal biopsy. Renal pathology indicated a diagnosis of acute interstitial nephritis. After starting prednisolone, his renal function slowly improved while INH was continued. A drug-induced lymphocyte stimulation test (DLST) of the antituberculous drugs did not reveal the causative agent. However, we consider RFP to be the most likely culprit.. In recent reports, renal failure is not a rare complication during antituberculous treatment in the elderly population. Physicians who are involved with the administration of antituberculous therapy have to be aware of this side effect. DLST is not useful for identifying the causative agent of antituberculous drug side effects. Leukocyte migration test may be more useful than DLST for this purpose, but further clinical studies are necessary to verify effectiveness.
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Topics: Antitubercular Agents; Ethambutol; Humans; Isoniazid; Male; Middle Aged; Nephritis, Interstitial; Rifampin; Tuberculosis, Pleural

Rifampin is one of the most important drugs in first-line therapies for tuberculosis. The renal toxicity of rifampin has been reported sporadically and acute tubulointerstitial nephritis (ATIN) is a frequent histological finding. We describe for the first time a case of ATIN and Fanconi syndrome presenting as hypokalemic paralysis, associated with the use of rifampin.. A 42-year-old man was admitted with sudden-onset lower extremity paralysis and mild renal insufficiency. He had been treated for pulmonary tuberculosis with isoniazid, rifampin, and ethambutol for 2 months. Laboratory tests revealed proteinuria, profound hypokalemia, hyperchloremic metabolic acidosis with a normal anion gap, positive urine anion gap, hypophosphatemia with hyperphosphaturia, hypouricemia with hyperuricosuria, glycosuria with normal serum glucose level, generalized aminoaciduria, and β2-microglobulinuria. A kidney biopsy revealed findings typical of ATIN and focal granular deposits of immunoglubulin A and complement 3 in the glomeruli and tubules. Electron microscopy showed epithelial foot process effacement and electron-dense deposits in the subendothelial and mesangial spaces. Cessation of rifampin resolved the patient's clinical presentation of Fanconi syndrome, and improved his renal function and proteinuria.. This case demonstrates that rifampin therapy can be associated with Fanconi syndrome presenting as hypokalemic paralysis, which is a manifestation of ATIN. Kidney function and the markers of proximal tubular injury should be carefully monitored in patients receiving rifampin.

Topics: Adult; Antibiotics, Antitubercular; Diagnosis, Differential; Fanconi Syndrome; Humans; Hypokalemia; Male; Nephritis, Interstitial; Paralysis; Rifampin

Acute tubulointerstitial nephritis (ATIN) as a complication of antituberculous therapy has been most commonly reported due to rifampicin therapy. This reaction typically occurs following re-exposure to the drug. This study undertook to investigate the clinicopathological features of ATIN related to antituberculous therapy.. We performed a retrospective study of all adult patients with a biopsy-proven diagnosis of ATIN on chemotherapy for tuberculosis. The patients presented with acute renal failure at our institution during 1995 - 2007. The demographic, clinical, biochemical and histopathological features were studied. The patient outcome and management were analyzed.. 41 patients had histologically proven ATIN. 23 (56%) were female. The mean age at presentation was 42 years. The most common regimen included rifampicin used intermittently to treat pulmonary tuberculosis. The average duration of antituberculosis therapy was 19 days before presentation and the duration of the acute illness averaged 5 days. The most common clinical manifestation included gastro-intestinal symptoms occurring in 35 (85%) patients with associated hepatitis biochemically in 20 (53%) patients. No skin rashes were observed and eosinophilia was only present in two patients. Hematuria was observed universally without any significant proteinuria. Anemia was present in 37 (90%) patients, with associated thrombocytopenia in 15 (37%). Rifampicin was discontinued in 37 (90%) cases. Nine (22%) patients required dialysis. One patient failed to recover renal function and 4 (10%) patients died. Mortality was related to overwhelming tuberculosis infection. The main factor predicting the need for dialysis was duration of oliguria.. ATIN is a rare, but serious complication of repeat antituberculous therapy mainly due to re-exposure to rifampicin. Although the renal prognosis is generally good the disease does carry significant morbidity and mortality risks. A high index of suspicion is needed in re-treatment patients. A suggested screening test is for microhematuria with urine dipstix.

Topics: Adult; Antitubercular Agents; Female; Humans; Male; Nephritis, Interstitial; Retrospective Studies; Rifampin

Topics: Acute Kidney Injury; Anemia, Hemolytic, Autoimmune; Antitubercular Agents; Diagnosis, Differential; Drug Therapy, Combination; Humans; Male; Middle Aged; Nephritis, Interstitial; Rifampin; Tuberculosis, Pulmonary

Topics: Acute Disease; Adult; Anti-Bacterial Agents; Biomarkers; Biopsy; Brucellosis; Creatinine; Humans; Male; Nephritis, Interstitial; Rifampin

A 26-year-old man was admitted to a hospital complaing of continuous high fever and abdominal swelling. As his sputum and ascites culture was positive for acid-fast bacilli and PCR-TB, he was diagnosed as miliary tuberculosis, tuberculous with pleuritis and peritonitis, and transferrd to our hospital. After initiation of treatment with isoniazid, rifampicin (RFP), ethambutol, and pyrazinamide, RFP was suspended because of direct-reacting hyperbilirubinemia. As the liver function recovered after discontinuation of RFP, low dose of RFP was re-administrated and renal dysfunction was observed. The renal dysfunction continued after discontinuation of suspicious drugs including RFP. As renal biopsy revealed interstitial nephritis, prednisolon 20 mg/day was started and renal function recovered quickly. From the clinical course and examination, we considered interstitial nephritis was due to re-administration of RFP and steroid therapy was effective.

Topics: Adult; Antitubercular Agents; Glucocorticoids; Humans; Male; Nephritis, Interstitial; Prednisolone; Rifampin; Tuberculosis, Miliary

Acute oliguric renal failure (ARF) developed in a patient 2 days after she was started on intermittent anti-Brucella therapy including rifampicin. The clinical picture was compatible with acute allergic interstitial nephritis. Renal histology revealed mainly acute tubular necrosis with mild tubulo-interstitial mononuclear cellular infiltrate. Intermittent therapy, as in our patient, has been the major factor in the development of rifampicin induced ARF in cases reviewed in literature.

Topics: Acute Disease; Brucellosis; Female; Humans; Middle Aged; Nephritis, Interstitial; Rifampin

Topics: Acute Disease; Adult; Antibiotics, Antitubercular; Brucellosis; Humans; Male; Nephritis, Interstitial; Rifampin

Topics: Acute Disease; Acute Kidney Injury; Antibiotics, Antitubercular; Biopsy; Humans; Kidney; Male; Middle Aged; Nephritis, Interstitial; Rifampin

Topics: Adult; Anemia, Hemolytic, Autoimmune; Antibiotics, Antitubercular; Humans; Male; Nephritis, Interstitial; Rifampin

We report the case of a 27-year-old Asian man who self-medicated with two capsules of rifampin 1 year after completing a continuous course of chemotherapy for tuberculosis that included that drug. He developed flank pain and edema and presented with uremia requiring dialysis; despite this, he had a serum potassium of only 3.5 mEq/L. Renal biopsy showed interstitial infiltrate with inflammation of the tubules. Renal function began to improve after a 3-week course of prednisone. This case is remarkable for the severity of the renal failure despite such a minimal self-exposure.

Topics: Acute Disease; Adult; Antibiotics, Antitubercular; Humans; Kidney; Male; Nephritis, Interstitial; Potassium; Prednisone; Rifampin; Self Medication; Tuberculosis, Pulmonary

Topics: Adult; AIDS-Associated Nephropathy; Antibiotics, Antitubercular; Biopsy; Female; Humans; Kidney; Nephritis, Interstitial; Nephrotic Syndrome; Rifampin

Rifampicin is one of the most effective antibiotics used for the treatment of tuberculosis and severe staphylococcal infections. Intermittent administration of high doses of rifampicin has been associated with frequent adverse reactions, including hepatotoxicity and nephrotoxicity, sometimes resulting in acute renal failure. We describe a case of rifampicin-associated acute renal failure, with biopsy findings of tubulointerstitial nephritis; inflammatory cells were characterized by immunohistochemistry, which showed immunoreactivity for CD3 and CD5 (T lymphocytes) and for CD68 (macrophages). The patient presented with a very rapid systemic reaction to the offending drug and rapid deterioration of renal function, which required dialysis treatment. The response to rifampicin discontinuation was excellent: no further therapy was required, as renal function began to improve within several days and returned to normal values (serum creatinine 1.17 mg/dl) seven months after the onset of symptoms. When prescribing rifampicin the physician should investigate previous use of the drug, because re-exposure is a critical factor in predicting the possibility of drug-induced acute renal failure.

Topics: Acute Disease; Acute Kidney Injury; Aged; Antibiotics, Antitubercular; Humans; Kidney; Male; Nephritis, Interstitial; Renal Dialysis; Rifampin; Tuberculosis, Pulmonary

An elderly patient with borderline tuberculoid Hansen's disease (leprosy) developed the diaminodiphenylsulphone syndrome after approximately 8 weeks of multi-drug therapy comprising dapsone and rifampicin. Postmortem histological examination, following autopsy, demonstrated features consistent with drug-induced hepatitis, tubulo-interstitial nephritis and myocarditis. Although these could have been engendered by dapsone toxicity, it was thought that a concommitant adverse reaction to rifampicin, which is known to be hepatotoxic, nephrotoxic and possibly capable of predisposing to the dapsone syndrome, could not be excluded.

Topics: Acute Kidney Injury; Aged; Chemical and Drug Induced Liver Injury; Dapsone; Diagnosis, Differential; Drug Therapy, Combination; Fatal Outcome; Humans; Kidney; Leprosy; Liver; Male; Myocarditis; Myocardium; Nephritis, Interstitial; Rifampin

While receiving continuous daily rifampin therapy, a 57-year-old man developed acute renal failure and nephrogenic diabetes insipidus due to acute tubulointerstitial nephritis which was reversible by discontinuing the rifampin. Tubulointerstitial nephritis rarely develops during continuous rifampin therapy, and associated nephrogenic diabetes insipidus has not previously been reported. The majority of cases of tubulointerstitial nephritis due to rifampin have occurred following reintroduction of rifampin after an interruption in therapy. The clinical differences between patients developing tubulointerstitial nephritis during interrupted and continuous therapy are discussed.

Topics: Acute Kidney Injury; Diabetes Insipidus; Humans; Male; Middle Aged; Nephritis, Interstitial; Rifampin; Tuberculosis

Topics: Acute Disease; Acute Kidney Injury; Adolescent; Adult; Aspirin; Dipyrone; Female; Humans; Male; Middle Aged; Nephritis, Interstitial; Rifampin

We report a patient who developed progressive renal failure following 13 months of rifampicin therapy for renal tuberculosis. The renal function continued to deteriorate despite the discontinuation of rifampicin. Renal pathology did not demonstrate any evidence of tuberculosis of the kidney but revealed the unique pathological finding of glomerulosclerosis, granulomatous interstitial nephritis, and extensive papillary necrosis.

Topics: Adult; Female; Glomerulosclerosis, Focal Segmental; Humans; Kidney Papillary Necrosis; Nephritis, Interstitial; Rifampin; Tuberculosis, Renal; Uremia

A patient with extensive pulmonary tuberculosis developed hypercalcaemia following rifampicin-induced interstitial nephritis.

Topics: Adult; Humans; Hypercalcemia; Male; Nephritis, Interstitial; Rifampin; Tuberculosis, Pulmonary

Topics: Humans; Nephritis, Interstitial; Rifampin; Tuberculosis, Pulmonary

A leprosy patient who developed acute renal failure on multidrug therapy is reported. The patient had initially received a once-weekly dose of rifampin and after he had stopped taking the drug for a time, was given rifampin on a once-monthly dose schedule. He recovered completely from his acute renal failure. Kidney biopsy showed interstitial nephritis with mononuclear and eosinophilic cellular infiltrates.

Topics: Acute Kidney Injury; Adult; Dapsone; Drug Hypersensitivity; Drug Therapy, Combination; Humans; Leprosy; Male; Nephritis, Interstitial; Rifampin

Rifampin is a widely used antimicrobial agent, most commonly administered in the treatment of tuberculosis. Since its introduction in the late 1960s, rifampin has become a standard agent in the treatment of tuberculosis, especially with the acceptance of short-course chemotherapy in the U.S. Rifampin also is being used with increasing frequency in the treatment of nontuberculous infections, especially serious staphylococcal infections. While rifampin usually is well tolerated in most patients, adverse effects, including serious forms of toxicity, have been reported. Some of these adverse effects include liver toxicity and various immunologic reactions such as skin rashes, eosinophilia, and interstitial nephritis. This report documents a case of acute interstitial nephritis, most likely secondary to intermittent rifampin administration.

Topics: Acute Disease; Female; Humans; Middle Aged; Nephritis, Interstitial; Rifampin; Self Administration

Topics: Adult; Drug Therapy, Combination; Humans; Male; Nephritis, Interstitial; Rifampin; Tuberculosis, Pulmonary

The benign, or infection-associated, haemophagocytic syndrome (IAHS) is a rare bone marrow disorder of macrophage cell proliferation diagnosed most commonly in immune compromised patients who develop herpes type viral infections (Risdall et al. 1979). It has also been reported in association with bacterial infections and rarely with mycobacterial infection (Chandra et al. 1975; Mamoharon & Catovsky 1981; Bultmann et al. 1982). Despite being potentially reversible it may produce a life-threatening pancytopenia (Seligman et al. 1972). We report a further case of the haemophagocytic syndrome associated with Mycobacterium tuberculosis in which thrombocytopenia was the predominant feature. There were unusual features in the clinical presentation and the patient's treatment and recovery were subsequently complicated by rifampicin-induced renal failure.

Topics: Bone Marrow; Humans; Male; Middle Aged; Myeloproliferative Disorders; Nephritis, Interstitial; Phagocytosis; Platelet Count; Rifampin; Syndrome; Thrombocytopenia; Tuberculosis, Pulmonary

Interstitial nephritis consequent to rifampin was associated with potassium wasting, an acidifying defect, high fractional uric acid excretion, and glucosuria, indicating a multiplicity of renal tubular transport abnormalities. Enlarged kidneys on sonogram and proteinuria were also observed.

Topics: Adult; Anti-Bacterial Agents; Humans; Hypokalemia; Kidney Tubules; Male; Nephritis, Interstitial; Potassium; Rifampin; Tuberculosis, Pulmonary; Uric Acid

Topics: Antitubercular Agents; Humans; Kidney; Nephritis, Interstitial; Rifampin

Topics: Acute Kidney Injury; Female; Humans; Middle Aged; Nephritis, Interstitial; Rifampin

Topics: Adult; Complement C3; Humans; Kidney Tubules; Male; Nephritis, Interstitial; Rifampin

We describe the clinical and pathological features of acute renal failure which occurred in a patient receiving a first course of antituberculous therapy, including daily rifampicin. Renal biopsy specimens demonstrated an interstitial nephritis. The renal lesion resolved three weeks after the cessation of rifampicin, as evidenced by improvement in renal function and the return of nuclear magnetic resonance tomographic studies to normal. This is only the fifth reported instance of renal impairment following continuous rifampicin therapy, despite widespread use of the drug in a daily dose. The possible toxic interaction of rifampicin and antituberculous drugs which are excreted predominantly by the kidneys is also described.

Topics: Acute Kidney Injury; Adult; Biopsy, Needle; Humans; Magnetic Resonance Spectroscopy; Male; Nephritis, Interstitial; Rifampin; Tuberculosis, Pulmonary

The immunohistological findings in 10 cases of DIHN and in 6 cases of R-ARF were compared with the patterns of experimental models and human examples of immunological nephritis. In most cases the simultaneous involvement of glomerular and extraglomerular structures was observed. A linear pattern on tubules together with a granular pattern on glomeruli and other structures was more frequently seen in Rifampicin adverse reactions. Direct and indirect immunofluorescence techniques performed in these last cases gave no evidence of the presence of the antigen and specific antibodies in the kidneys.

Topics: Adult; Aged; Animals; Basement Membrane; Drug Hypersensitivity; Female; Fluorescent Antibody Technique; Humans; Kidney; Kidney Glomerulus; Kidney Tubules; Male; Middle Aged; Nephritis; Nephritis, Interstitial; Rats; Rifampin; Sulfonamides

A patient who was receiving rifampin treatment for tuberculosis developed heterogenous light-chain proteinuria and insidious renal failure after a period of fluid restriction. The renal damage was characterized pathologically by an interstitial nephritis with invasive tubular casts and an associated renal vein thrombosis. The possible role of the light-chain proteinuria in the pathogenesis of the renal failure is discussed.

Topics: Acute Kidney Injury; Dehydration; Humans; Immunoglobulin Light Chains; Male; Middle Aged; Nephritis, Interstitial; Proteinuria; 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

Topics: Acute Kidney Injury; Adult; Humans; Kidney; Male; Nephritis, Interstitial; Peritonitis, Tuberculous; Rifampin

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

Topics: Acute Disease; Acute Kidney Injury; Anticoagulants; Contraceptives, Oral; Digitoxin; Female; Hemolysis; Humans; Nephritis, Interstitial; Rifampin; Thrombocytopenia; Tuberculosis

Topics: Acute Kidney Injury; Adult; Humans; Male; Nephritis, Interstitial; Rifampin

Topics: Acute Kidney Injury; Anti-Bacterial Agents; Cephalexin; Cephaloridine; Cephalothin; Drug Hypersensitivity; Gentamicins; Humans; Kanamycin; Kidney Diseases; Kidney Tubules; Nephritis; Nephritis, Interstitial; Penicillins; Polyenes; Polymyxins; Rifampin