rifampin and Urticaria

Topics: Adult; Aged; Antibiotics, Antitubercular; Clinical Trials as Topic; Desensitization, Immunologic; Female; Humans; Hypersensitivity, Immediate; Immune Tolerance; Immunoglobulin E; Injections, Intravenous; Intradermal Tests; Leprostatic Agents; Male; Middle Aged; Rifampin; Urticaria

Desensitization with drugs may be indicated in some clinical situations. Apart from large experiences with beta-lactam antibiotics and cotrimoxazole in HIV infection, experience with other drugs is limited. Rifampicin may elicit exanthema and urticaria, and their pathomechanisms are not known in detail. Since therapy with rifampicin may be indispensable in mycobacterial infections or against multiresistant Staphylococcus aureus, desensitization may be indicated in some patients.. Report of immediate hypersensitivity to rifampicin and description of diagnostic and desensitization procedures.. We report 3 patients with immediate urticarial reactions to rifampicin. Diagnostic procedures included skin and in vitro tests (specific IgE, lymphocyte transformation test, LTT, and CAST). The non-irritant cutoff concentration was evaluated in 24 volunteers. A 7-day desensitization procedure was used.. Only intradermal tests at a dilution of at least 1:10,000 (concentration of rifampicin approximately 0.006 mg/ml) were true positive, whereas in vitro tests (IgE, LTT and CAST) did not correctly identify hypersensitive patients. Two patients had positive accidental reexposure. All patients were successfully desensitized with rifampicin according to a slow 7-day protocol.. Rifampicin rarely elicits immediate hypersensitivity symptoms which may be diagnosed by intradermal skin tests. In vitro tests did not contribute to the diagnosis. Therefore, an IgE-mediated mechanism remains to be proven. Desensitization with rifampicin using different protocols has been reported. In our 3 cases, clinical tolerance to rifampicin was achieved using a 7-day protocol.

Topics: Adult; Aged; Antibiotics, Antitubercular; Desensitization, Immunologic; Female; Humans; Hypersensitivity, Immediate; Immune Tolerance; Immunoglobulin E; Injections, Intravenous; Intradermal Tests; Leprostatic Agents; Male; Middle Aged; Rifampin; Urticaria

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

A case of fixed drug eruption due to rifampin in a leprosy patient is described. Fixed drug eruption due to rifampin with the classical residual hyperpigmentation has not been described before.

Topics: Adult; Drug Eruptions; Female; Humans; Leprostatic Agents; Leprosy, Tuberculoid; Rifampin; Urticaria

Topics: Adult; Drug Eruptions; Erythema Nodosum; Female; Humans; India; Leprostatic Agents; Leprosy, Lepromatous; Rifampin; Urticaria

Topics: Adult; Drug Administration Schedule; Drug Eruptions; Humans; Leprosy; Male; Respiration Disorders; Rifampin; Urticaria

The aim of this prospective study was to evaluate the incidence of allergic reactions to drugs compared to other kinds of medical emergencies admitted to the main Hospital in Milan during a 6 months period. At the same time we drew a list of drugs most frequently involved in allergic reactions, and a list of the most frequent symptoms. Using special forms, the medical staff collected patients' data: age, history of atopy, identification of the drug causing the reaction, and any previous reactions. Among 11,407 cases of medical emergencies, we found 163 (1.43%) patients showing drug reactions: the mean age was 27.3; 58.90% were female; atopy was present in 16.56%. The drugs most frequently involved were: pyrazon group (22%); ASA (20.86%); penicillin and derivatives (9.20%); sulfa drugs (6.14%); group B vitamins (4.30%); tetanus toxoid (4.30%); hyposensitizing extracts (3.68%); propionic acid derivatives (2.46%); paracetamol (1.84%); indomethacin (1.23%); rifampicin (1.23%); erythromycin (1.23%); glafenine (1.23%); others (17.80%). Urticaria and/or angioedema were the most frequent symptoms (86.51%), then anaphylactic shock (9.81%) and asthma (3.68%) with regard to anaphylactic shock only 6.20% of the patients had had a previous reaction to the same drug. From these data we can see that the incidence of drug reactions is very low compared to other medical emergencies; penicillin evidenced fewer reactions than expected, while the pyrazon group and ASA confirmed the data from literature.

Topics: Acetaminophen; Adult; Anaphylaxis; Angioedema; Aspirin; Asthma; Drug Hypersensitivity; Emergencies; Erythromycin; Female; Glafenine; Humans; Indomethacin; Italy; Male; Penicillins; Propionates; Prospective Studies; Pyridazines; Rifampin; Urticaria; Vitamin B Complex