利福平引起的急性肾功能衰竭及其机制研究(3例报告及文献复习)

目的：探讨利福平致急性肾功能衰竭的临床病理特点及其发病机制。方法：对3例因利福平所致的急性肾衰竭患者的临床、肾脏病理进行分析，并采用抗人球蛋白试验方法检测患者的抗利福平抗体。结果：3例患者均有前驱感染史，临床主要表现为发热、胃肠道症状，随即出现无尿，伴随肾功能损害、血小板减低及溶血性贫血，部分伴有肝功能损害。肾活检3例均为急性肾小管坏死。3例的血清抗利福平抗体检测均为阳性。结论：利福平可引起急性肾衰竭，对应用利福平的患者应加强对肾功能的监测，肾脏病理及血清抗利福平抗体的检测有助于确诊。

Rifampicin- induced acute renal failure and its pathogenesis (report of 3 cases and literature review)

Objective To describe the clinico-pathological features and explore the pathogenesis of rifampicin-associated acute renal failure (ARF).?Methods Clinico-pathological features of 3 patients with rifampicin-associated ARF were analyzed. Rifampicin-dependent antibody in the patient's serum was detected by Coomb's test.?Results The 3 patients all had a history of using the drug in the past. The clinical features of the illness were first characterized by fever and gastrointestinal symptoms after intake of rifampicin. Anuria then developed abruptly, which was accompanied by renal dysfunction, thrombocytopenia and hemolytic anemia, and sometimes also by impaired liver function. Renal biopsy revealed acute tubular necrosis. Serum rifampicin dependent antibody was positive in all of the 3 cases.?Conclusion Rifampicin can induce acute renal failure. Renal function should be closely monitored in the susceptible patients. Renal biopsy and detection of serum rifampicin-dependent antibody will help establish the diagnosis of rifampicin induced ARF.