Nessi R, Bonoldi G L, Redaelli B, di Filippo G
Nephron. 1976;16(2):148-59. doi: 10.1159/000180596.
A new case of acute renal failure after rifampicin is presented, together with a review of the 36 similar cases published up to date in the literature. Evidence is provided that irregularities in drug intake, either as true intermittent treatment or as discontinuation of continuous therapy, play an important role in the pathogenesis of such reactions. Renal failure appeared after a rather long uneventful interval from the beginning of rifampicin therapy, ranging from 1 month to more than 1 year. Its clinical course was favourable in all but one case; the histological picture was mainly of tubulo-interstitial type. The controversial immunological data reported in the literature are reviewed; an increase of histamine release by rat mast cells has been found in presence of rifampicin plus the serum of our patient: the implications of this finding are discussed, suggesting a possible immunological factor in the pathogenesis of acute renal failure after rifampicin.
本文报告了1例利福平治疗后发生急性肾衰竭的新病例，并对文献中迄今发表的36例类似病例进行了综述。有证据表明，药物摄入不规律，无论是真正的间歇治疗还是连续治疗中断，在此类反应的发病机制中起重要作用。肾衰竭出现在利福平治疗开始后的一段相当长的平稳期之后，间隔时间从1个月到1年多不等。除1例病例外，所有病例的临床病程均良好；组织学表现主要为肾小管间质型。对文献中报道的有争议的免疫学数据进行了综述；在利福平加患者血清存在的情况下，发现大鼠肥大细胞组胺释放增加：讨论了这一发现的意义，提示利福平治疗后急性肾衰竭发病机制中可能存在免疫因素。
