Manasia M, Paul G, Maniţiu P I
Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol. 1976 Jul-Sep;25(3):183-8.
In the last two years the authors have noted the cases of five patients with pulmonary tuberculosis to which intermittent treatment with Rifampicin was administered (twice weekly, 600-900 mg/day), in association with Ethambutol. Between 2 and 6 months after the treatment was started, 24-72 hours after the last administration of Rifampicin acute renal failure developed in all five cases. Two of the patients also had signs of liver failure (increased serum transaminase, lowered pseudo-cholinesterase, increased BSP retention), and in one of them there was also a hematological syndrome consisting in hemolytic anemia and thrombocytopenia. Four of the patients benefited from application of diuretics, hydroelectrolytic re-equilibration and/or hemodialysis. One of the subjects died 12 hours after being hospitalized, with acute pulmonary oedema, refractory to treatment. From the histopathological viewpoint glomerular lesions were found in the kidney (non-uniform thickening of the basal membranes by PAS-positive deposits). In two of the patients various immunological tests have been carried out (Coombs test, lymphocyte-migration inhibition, serum and urine immunelectrophoresis) that, by their alterations, provide some elements indicating the immunological origin of the phenomena.
在过去两年中，作者注意到5例肺结核患者，对其采用利福平间歇治疗（每周两次，600 - 900毫克/天），并联合乙胺丁醇。在开始治疗后的2至6个月内，所有5例患者在最后一次服用利福平后24 - 72小时均出现急性肾衰竭。其中2例患者还出现肝功能衰竭迹象（血清转氨酶升高、假性胆碱酯酶降低、磺溴酞钠潴留增加），其中1例还出现血液学综合征，表现为溶血性贫血和血小板减少。4例患者通过应用利尿剂、水电解质重新平衡和/或血液透析而获益。其中1例患者在住院12小时后死亡，死于急性肺水肿，治疗无效。从组织病理学角度看，在肾脏发现了肾小球病变（PAS阳性沉积物导致基底膜不均匀增厚）。对其中2例患者进行了各种免疫学检查（库姆斯试验、淋巴细胞游走抑制试验、血清和尿液免疫电泳），这些检查结果的改变为这些现象的免疫起源提供了一些线索。
