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Kim, Park, Son, Jung, Ahn, Jung, Lim, Jung, Moon, Byun, Kim, Kim, Chang, Lee, and Park: A Case of Henoch-Shönlein Purpura Caused by Rifampin
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(2): 116-120.

Published online: 31 August 2008

DOI: https://doi.org/10.4046/trd.2008.65.2.116

A Case of Henoch-Shönlein Purpura Caused by Rifampin

Hye Ryun Kim, M.D.1, Byung Hoon Park, M.D.1, Ji-Young Son, M.D.1, Ji Ye Jung, M.D.1, Jung Ryun Ahn, M.D.1, Yoon Suk Jung, M.D.1, Ju Eun Lim, M.D.1, Ju Won Jung, M.D.1, Ji Ae Moon, M.D.1, Min Kwang Byun, M.D.1, Young Sam Kim, M.D.1, 3, Se Kyu Kim, M.D.1, 3, Joon Chang, M.D.1, 3, Kwang Kil Lee, M.D.2, Moo Suk Park, M.D.1, 3

1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

2Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.

3The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.

Address for correspondence: Moo Suk Park, M.D. Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, 120-752, Korea. Phone: 82-2-2228-1974, Fax: 82-2-393-6884, pms70@yuhs.ac

Received 14 April 2008       Accepted 3 July 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Rifampin is one of the first line drugs for treating tuberculosis, but it might be associated with serious adverse effects, including renal failure. We report here on a case of a 57-year-old patient who developed Henoch-Shönlein purpura during antituberculosis therapy that included rifampin. The patient converted to negative on the AFB smear for tuberculosis two weeks after the initial administration of antituberculosis medication. After treatment for 60 days, this patient was diagnosed with Henoch-Shönlein purpura by the purpura lesion on the lower legs, the leukocytoclastic vasculitis, the renal impairment and the pathological examination. After stopping rifampin, the skin lesions disappeared in about 10 days and his renal function gradually improved. This case study showed that Henoch-Schönlein purpura can be caused by rifampin during antituberculosis therapy and we recommend that the use of rifampin should be restrained when clinical symptoms of Henoch-Shönlein purpura are observed.

Keywords: Acute renal failure, Henoch-Shönlein purpura, Rifampin, Tuberoculosis

Figures and Tables

Figure 1
Chest X-ray showed underlying chronic obstructive pulmonary disease and tuberculosis sequale in both upper lungs.
trd-65-116-g001
Figure 2
Palpable purpura on both lower extremities.
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Figure 3
Pathologic finding of skin biopsy showed leukocytoclastic vasculitis (H&E stain, ×400).
trd-65-116-g003
Table 1
Clinical feature and laboratory data of patient
trd-65-116-i001

HOD: hospitalization of day; Tx day: treatment day; ND: not done.

*isoniazid 300 mg, rifampin 450 mg, ethambutol 800 mg, pyrazinamide 1,250 mg, †isoniazid 300 mg, ethambutol 800 mg (QOD), pyrazinamide 1,250 mg (QOD), ‡isoniazid 300 mg, ethambutol 800 mg (daily), pyrazinamide 1,250 mg (daily).

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