rifampin and Nephritis

Topics: Acute Kidney Injury; Administration, Intravesical; Aged; Antitubercular Agents; BCG Vaccine; Ethambutol; Humans; Isoniazid; Kidney; Male; Nephritis; Renal Insufficiency, Chronic; Rifampin; Treatment Outcome; Urinary Bladder Neoplasms

Topics: Antibiotics, Antitubercular; Desensitization, Immunologic; Drug Hypersensitivity; Female; Hepatitis; Humans; Hypersensitivity, Immediate; Injections, Intravenous; Middle Aged; Nephritis; Rifampin; Tuberculosis, Lymph Node; Urticaria

Antibiotics are the principal cause of drug-associated nephropathy. They are responsible for acute interstitial nephropathy (AIN) or acute tubulo-interstitial nephropathy (ATIN) due to two different pathophysiologic mechanisms: a drug-induced immunologic process and direct action due to drug accumulation. 1) Ain of immunologic origin. These are rare and are induced either by beta-lactamines or by rifampicin. Among the beta-lactamines, methicillin is the most often responsible, while penicillin and ampicillin are less often, and only rarely are carbenicillin, oxacillin, nafcillin, cephalothin and cephalexin. Macroscopic hematuria occurring 10 to 15 days after initiation of treatment usually reveals the renal involvement. It is associated with or preceded by fever, skin eruption and blood eosinophilia. Renal insufficiency (RI) is not severe and rarely requires hemodialysis (HD). The course is usually favorable. Rifampicin-induced AIN is observed in two circumstances, either during intermittent treatment or when previous treatment is resumed. Macroscopic hematuria is rare and RI often severe. Anti-rifampicin anti-bodies are usually found. 2) ATIN due to direct toxicity. Several classes of antibiotics may be responsible: cephalosporins, polymyxins or cyclins, but it is usually observed with aminoglycosides (AG). The incidence of renal involvement due to the latter group is estimated to be 4 to 10%. Nephrotoxicity is initially reflected by polyuria, tubular proteinuria and increased enzymuria, followed by cylindruria and reduced glomerular filtration. HD is rarely required. The proximal tubule is predominantly affected; pathological findings are disappearance of the brush border and tubular necrosis. Electronic microscopy shows lysosomal alterations with numerous myelinic bodies. Tubular regeneration occurs within 15 to 30 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aminoglycosides; Anti-Bacterial Agents; Cephalosporins; Drug Hypersensitivity; Humans; Nephritis; Polymyxins; Rifampin; Tetracyclines

Topics: Humans; Kidney; Male; Middle Aged; Nephritis; Rifampin

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

Starting again a Rifampicin treatment gave rise to an acute renal insufficiency, reversible by hemodialysis. This incident resulted from an immunopathological conflict revealed by the presence of anti-Rifampicin antibodies. Renal needle biopsy did not show any immune deposits. The mechanism of these incidents is discussed. Authors draw attention to the necessity of avoiding discontinuous Rifampicin treatment.

Topics: Acute Kidney Injury; Biopsy, Needle; Drug Hypersensitivity; Female; Humans; Kidney Tubules; Middle Aged; Nephritis; Renal Dialysis; 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 Kidney Injury; Anti-Bacterial Agents; Cephalexin; Cephaloridine; Cephalothin; Drug Hypersensitivity; Gentamicins; Humans; Kanamycin; Kidney Diseases; Kidney Tubules; Nephritis; Nephritis, Interstitial; Penicillins; Polyenes; Polymyxins; Rifampin