Letter to the Editor

Life-threatening, Multiple Hypersensitivity Reactions Induced by Rifampicin in One Patient with Pulmonary Tuberculosis

Authors: Roberto Luzzati, MD, Donatella Giacomazzi, MD, Fabio Franchi, MD, Monica Barcobello, MD, Sandro Vento, MD


To the Editor:

Rifampicin (RFP) is one of the most effective antibiotics available for the treatment of tuberculosis. Its best known side effect is liver toxicity. Fewer than 4% of patients have immunoallergic reactions such as rash, fever, nausea, and vomiting.1 More severe hypersensitivity reactions are uncommon and occur in cases of intermittent regimens, high-dose administration, prior treatment with RFP, or HIV infection.2 We report one such case in a patient without HIV infection.

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2. Martinez E, Collazos J, Mayo J. Hypersensitivity reactions to rifampin. Medicine 1999;78:361–369.
3. Petz LD, Branch DR. Drug-induced immune hemolytic anemia. Methods in hematology: Immune hemolytic anemias. Chaplin H (ed). Churchill Livingstone, New York, 1985: pp 47–94.
4. Muthukumar T, Jayakumar M, Fernando EM, et al. Acute renal failure due to rifampicin: a study of 25 patients. Am J Kidney Dis 2002;40:690–696.
5. De Vriese AS, Robbrecht DL, Vanholder RC, et al. Rifampicin-associated acute renal failure: pathophysiologic, immunologic, and clinical features. Am J Kidney Dis 1998;31:108–115.