Chogtu Bharti, Surendra Vyshak Uddur, Magazine Rahul, Acharya Preetam Rajgopal, Yerrapragada Devesh Bhaskar
Associate Professor, Department of Pharmacology, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .
Postgraduate Student, Department of Pulmonary Medicine, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .
J Clin Diagn Res. 2016 Sep;10(9):OD18-OD19. doi: 10.7860/JCDR/2016/21030.8578. Epub 2016 Sep 1.
Adverse drug reactions are not unusual during Anti-Tubercular Therapy (ATT). One of the common complications of anti-tubercular treatment is drug induced hepatitis and renal insufficiency has also been reported. Renal failure and/or hepatitis encountered during treatment of tuberculosis can have varied aetiologies: drug induced, concomitant viral infection, pre-existing co-morbidities or a combination of these. Since, hepatitis and/or renal insufficiency can be life threatening a prompt diagnosis is warranted, where drugs should be kept as one of the important cause. Identifying the drug helps in treating hepatitis and/or renal insufficiency along with helping the physician to change the combination of ATT regimen. Rifampicin is one of the most important first line drugs in the treatment of tuberculosis. Hepatitis, epigastric distress, anaemia, thrombocytopenia, and interstitial nephritis are reported adverse drug reactions to rifampicin. As per literature rifampicin induced renal toxicity is usually seen on rifampicin re-exposure, or rifampicin administration on alternate days, both being present in this case. Here we are reporting a case of ATT induced renal failure with concomitant hepatitis where rifampicin was suspected to be the cause.
抗结核治疗（ATT）期间药物不良反应并不罕见。抗结核治疗的常见并发症之一是药物性肝炎，也有报道出现肾功能不全。结核病治疗期间遇到的肾衰竭和/或肝炎可能有多种病因：药物性、合并病毒感染、既往并存疾病或这些因素的组合。由于肝炎和/或肾功能不全会危及生命，因此需要及时诊断，其中药物应被视为重要病因之一。确定药物有助于治疗肝炎和/或肾功能不全，同时帮助医生改变抗结核治疗方案的组合。利福平是治疗结核病最重要的一线药物之一。据报道，利福平的药物不良反应包括肝炎、上腹部不适、贫血、血小板减少和间质性肾炎。根据文献，利福平引起的肾毒性通常在再次接触利福平或隔日服用利福平时出现，本病例中这两种情况都存在。我们在此报告一例抗结核治疗引起的肾衰竭合并肝炎病例，怀疑病因是利福平。
