[Manifestations of rifampicin-induced hypersensitivity]

(Manifestations d'hypersensibilité à la rifampicine.)

Full Abstract

INTRODUCTION: The side effects of rifampicine due to an immunoallergic mechanism are rare and usually observed during discontinued treatment or administration of high doses. OBSERVATIONS: An immediate hypersensitivity reaction with anaphylactic manifestations and increase in IgE occurred in a 39 year-old man suffering from resistant tuberculosis. The reaction occurred within the first hour following a low dose of rifampicin administered in a desensitisation attempt, the outcome of which was favourable after administration of corticosteroids and antihistamines. A type II hypersensitivity reaction occurred in a 76 year-old male patient in the form of thrombopenia on D76 of a twice weekly treatment, diagnosed because of hemoptysis with normalisation of platelet level on withdrawal of rifampicin. An immune complex hypersensitivity reaction was responsible for hepato-renal failure on D68 of twice weekly treatment and required permanent withdrawal of rifampicin and dialysis, which led to subsequent improvement. COMMENTS: These clinical cases illustrate the variability of the hypersensitivity mechanisms observed with rifampicin, the difficulty in imputability tests and methods for immunological confirmation, the interest of continuous treatment which avoids a certain number of these accidents, and that of desensitisation during immediate hypersensitive reactions which permits the continuation this major anti-tuberculosis drug.

Author information

Author/s: Fenniche, Soraya (S); Maalej, Sonia (S); Fekih, Leila (L); Hassene, Hela (H); Belhabib, Dalenda (D); Megdiche, Mohamed Lamine (ML);

Affiliation: Service Ibn Nafiss, Hôpital Abderrahmen Mami, Ariana 2080, Tunisie.

Journal and publication information

Publication Type: Case Reports; English Abstract; Journal Article

Journal: Presse médicale (Paris, France : 1983) (Presse Med), published in France. (Language: fre)

Reference: 2003-Jul; vol 32 (issue 25) : pp 1167-9

Dates: Created 2003/09/18; Completed 2003/10/06; Revised 2006/11/15;

PMID: 13677879, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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