Immune Hemolytic Anemia and Acute Tubular Necrosis by Rifampicin Dependent Antibodies that Mimicked Hemolytic Uremic Syndrome.
- Author:
Young Jae LEE
1
;
Suk Young KIM
;
Dae Keun LO
;
Woo Chul CHUNG
;
Sung Ro YUN
;
Jong Min LEE
;
Sun Ae YOON
;
Suk Joo AHN
;
Byoung Kee BANG
;
Hee Jung KIM
;
Kwang Sun SUH
Author Information
1. Department of Internal Medicine, College of Medicine Catholic University, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Rifampicin;
ARF;
ATN;
DIC;
Hemolytic anemia;
HUS
- MeSH:
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
- From:Korean Journal of Nephrology
1997;16(4):814-819
- CountryRepublic of Korea
- Language:Korean
-
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.
