rifampin and Pemphigus

Pemphigus vulgaris (PV) is a rare life-threatening condition of the pemphigus group of autoimmune blistering diseases. Systemic glucocorticoids are the cornerstone of management for PV, but complications can arise from their long-term use. We report a case of recurrence of a well-controlled case of PV that could not be alleviated by a combination of steroids, mycophenolate mofetil, and high-dose intravenous immune proteins. The patient had developed numerous complications during previous glucocorticoid therapy, including hypertension, diabetes, glaucoma, cataracts, optic nerve atrophy, aseptic necrosis of the femoral head, osteoporosis, and pulmonary tuberculosis. We determined that recurrence of PV and treatment resistance were consequences of the interaction between the antitubercular agent rifampicin that the patient was taking and corticosteroids. Pemphigus vulgaris was quickly controlled after the rifampicin was discontinued.

Topics: Autoimmune Diseases; Crime; Humans; Immunosuppressive Agents; Mycophenolic Acid; Pemphigus; Rifampin

Topics: Humans; Pemphigus; Rifampin

Topics: Drug Interactions; Humans; Male; Middle Aged; Pemphigus; Prednisolone; Rifampin

Rifampicin therapy caused exacerbation of skin lesions, rising serum pemphigus antibody titres, and decreased serum betamethasone levels in a 59-year-old man with pemphigus vulgaris. Exacerbation of pemphigus was confined to the period of rifampicin therapy and seems to be best explained by the effect of rifampicin on the metabolism of betamethasone. Physicians prescribing rifampicin for the treatment of tuberculosis should be aware of its potential to produce such an important adverse reaction.

Topics: Betamethasone; Humans; Male; Middle Aged; Pemphigus; Rifampin; Tuberculosis, Pulmonary

Pemphigus foliaceus was seen in a patient with pulmonary tuberculosis during rifampicin therapy. The skin lesions were eczematoid patches, flaccid bullae and crusted plaques on the trunk and extremities, histologically showing a high epidermal blister with acantholysis. The diagnosis was confirmed by immunofluorescent studies. After the patient discontinued rifampicin, the skin lesions cleared completely within 5 weeks without any systemic medication.

Topics: Humans; Isoniazid; Male; Middle Aged; Pemphigus; Pyridoxine; Rifampin; Tuberculosis, Pulmonary

Topics: Aged; Chemical and Drug Induced Liver Injury; Female; Humans; Liver Function Tests; Pemphigus; Prednisone; Remission, Spontaneous; Rifampin; Tuberculosis, Renal