Korean J Nephrol.
1997 Dec;16(4):814-819.
Immune Hemolytic Anemia and Acute Tubular Necrosis by Rifampicin Dependent Antibodies that Mimicked Hemolytic Uremic Syndrome
- Affiliations
-
- 1Department of Internal Medicine, College of Medicine Catholic University, Seoul, Korea.
- 2Department of Clinical Pathology, College of Medicine Catholic University, Seoul, Korea.
- 3Department of Pathology, College of Medicine Chung Nam National University, Dae Jeon, Korea.
Abstract
- A 52-year-old male admitted the hospital because of the spontaneous pneumothorax. About twenty years ago, he had experienced the pulmonary tuberculosis but he did not medicine the antituberculosis regulary. The pleural biopsy during right lobectomy and closed thoracotomy revealed the pleural tuberculosis and we instituted the re-trial of antituberculosis medication Acute oliguric renal failure occurred after the medications for seven days. The blood smear showed the evidence of microangiopathic hemolysis. We regarded the HUS deveoloped in this patient and four times of plasma exchage was accomplished. But the renal biopsy revealed the acute tubular necrosis due to the pigment nephropathy with interstitial inflammation and the careful laboratory evaluation showed the massive hemolysis with the compensated DIC. The rifampicin dependent antibodies were identified by indirect antiglobulin test. The microangiopathic finding would be due to DIC. We regarded that the renal failure was due to the hemolysis and, in minor part, was due to interstitial nephritis. Total plasma exchage, hemodialysis and prednisolone teatment resolved the hemolysis and the renal failure in this patient.
Keyword
- Rifampicin; ARF; ATN; DIC; Hemolytic anemia; HUS
MeSH Terms
-
Anemia, Hemolytic*
Antibodies*
Biopsy
Coombs Test
Dacarbazine
Hemolysis
Hemolytic-Uremic Syndrome*
Humans
Inflammation
Male
Middle Aged
Necrosis*
Nephritis, Interstitial
Plasma
Pneumothorax
Prednisolone
Renal Dialysis
Renal Insufficiency
Rifampin*
Thoracotomy
Tuberculosis, Pleural
Tuberculosis, Pulmonary
Antibodies
Dacarbazine
Prednisolone
Rifampin
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