書誌事項
- タイトル別名
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- A Case of Acute Renal Failure after Intermittent Rifampicin Therapy
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This report presents a 49 years-old Japanese woman who suffered from acute renal failure after intermittent administration of rifampicin.<br>Since November 1949, she has been in Japanese National Sanatorium Oshima Seishoen, because she was diagnosed as lepromatous leprosy at April 1949. She was administrated with promin and DDS after the admission to the sanatorium. DDS was discontinued between January 1981 and October 1981, because her bacterial index was kept negative.<br>At October 1981, exanthema appeared on her face, and diagnosed as relapse of leprosy. Since 2 November 1981, she has been administered with DDS from 50mg to 75mg daily and rifampicin from 150mg to 450mg daily. But rifampicin therapy was stopped 5 times in the period from 2 November 1981 to 16 August 1983, because swelling of extremities and face, face-ache, iritis of left eye and left drop foot developed.<br>Her bacterial index being kept positive, she was administered with 1350mg (9 capsels) of rifampicin from June to 16 August 1983. An oliguria appeared at 15 August 1983, and at the morning of 16 August, an anuria with high fever, head-ache, nausea and edema on her face appeared suddenly.<br>Proteinuria and hematuria were observed by urinalysis. The value of s-BUN was 46.7mg/dl and the value of s-creatinine was 5.7mg/dl by biochemical examination. The anuria continuing, she was diagnosed as acute renal failure, and she was sent to Takamatsu Red Cross Hospital, Department of urology. Immediately after the admission to Takamatsu Red Cross Hospital, continuous peritoneal dialysis was done.<br>Total amount of urine become about 500_??_1200ml daily and renal function was improved gradually at October 1983. The humoral and cell mediated immunities were examined at August 1983, and all of the data were within normal values. Renal open biopsy specimen was taken at 2 November 1983. Proliferation of the renal mesangial and endothelial cells and increase of the mesangial matrix were observed sligtly. Remarkable necrosis was observed in the tubulal epithelial cells by electron microscopic examination. Fibronecten was positive as diffuse mesagial granular pattern, but IgG, IgM, IgA or complements were not found by immunofluorescent examination.<br>According to the clinical course, laboratory data and histopathological findings, it wasconsidered that the acute renal failure was induced by ntermittent rifampicin therapy.
収録刊行物
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- 日本らい学会雑誌
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日本らい学会雑誌 53 (4), 193-199, 1984
日本ハンセン病学会