Publicado

2020-01-01

Acute tubulointerstitial nephritis due to the use of rifampicin. Case report

Nefritis tubulointersticial aguda por uso de rifampicina. Reporte de caso

DOI:

https://doi.org/10.15446/cr.v6n1.80443

Palabras clave:

Nephritis, Interstitial, Acute Kidney Injury, Rifampin (en)
Nefritis intersticial, Lesión renal aguda, Rifampicina (es)

Autores/as

  • Juan Camilo Motta Universidad del Rosario - School of Medicine and Health Sciences - Specialization in Internal Medicine - Bogotá D.C. - Colombia https://orcid.org/0000-0002-0847-7343
  • Camilo Andrés Rodríguez Universidad del Rosario - School of Medicine and Health Sciences - Specialization in Internal Medicine - Bogotá D.C. - Colombia https://orcid.org/0000-0003-4684-050X
  • Camilo Cortes Universidad del Rosario - School of Medicine and Health Sciences - Specialization in Internal Medicine - Bogotá D.C. - Colombia. Hospital Universitario Mayor Méderi - Internal Medicine Service - Bogotá D.C. - Colombia https://orcid.org/0000-0003-2061-9567
  • Jaime Escobar Hospital Universitario Mayor Méderi - Inpatient Department - Bogotá D.C. - Colombia https://orcid.org/0000-0003-0224-4298

Introduction: Rifampin is a cornerstone for the first phase of the treatment of pulmonary tuberculosis. This report presents the case of a patient with allergic tubulointerstitial nephritis (ATIN) due to rifampin, situation that has not been reported in Colombia.

Case presentation: A male patient with a history of pulmonary tuberculosis treated with rifampin developed acute kidney injury. On admission, no evidence of abnormalities or history to explain the injury was found, but he did present tubular acidosis and associated Fanconi syndrome. The kidney injury was temporarily consistent with rifampicin use, and a kidney biopsy confirmed ATIN. The drug was suspended, resulting in improved kidney function.

Discussion: ATIN as a side effect of rifampin is a scarcely reported disease. The risk of developing this condition should be considered when starting and restarting treatments with this medication.

Conclusion: ATIN is one of the side effects of tuberculosis treatment. Albeit rare, it should be considered when starting tuberculosis medications.

Introducción. La rifampicina es un medicamento fundamental en la primera fase del tratamiento en la tuberculosis pulmonar; sin embargo, esta puede causar nefritis tubulointersticial aguda (NTIA) en raras ocasiones.

Presentación del caso. Paciente masculino con antecedentes de tuberculosis y en tratamiento con rifampicina, quien desarrolló lesión renal aguda. Al ingreso, el sujeto no registró anormalidades o antecedentes que explicaran lesión renal, pero sí presentaba acidosis tubular y síndrome de Fanconi asociado. La lesión renal concordó temporalmente con el uso de rifampicinay una biopsia de riñón confirmó NTIA. Se ordenó suspender el medicamento, con lo cual la función renal mejoró.

Discusión. La NTIA como un efecto secundario de la rifampicina es una enfermedad poco reportada, por tanto, al iniciar y al reiniciar el manejo con este medicamento se debe tener en cuenta el riesgo de desarrollarla.

Conclusión. La NTIA es uno de los efectos secundarios del tratamiento de la tuberculosis y, aunque es raro, debe tenerse en cuenta al iniciar el esquema de medicamentos para la tuberculosis.

Referencias

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Cómo citar

Motta, J. C., Rodríguez, C. A., Cortes, C., & Escobar, J. (2020). Nefritis tubulointersticial aguda por uso de rifampicina. Reporte de caso. Case Reports, 6(1), 44-51. https://doi.org/10.15446/cr.v6n1.80443