Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Dec 9;11(1):e227356.
doi: 10.1136/bcr-2018-227356.

Rifampicin: not always an innocent drug

Dafni Sveroni  1 , Aggelos Stefos  1 , Eirini I Rigopoulou  1   2 , Georgios N Dalekos  1   2
Affiliations
Case Reports

Rifampicin: not always an innocent drug

Dafni Sveroni et al. BMJ Case Rep. .

Abstract

Rifampicin has been widely used due to its broad antibacterial spectrum. Acute haemolysis is a rarely encountered complication of rifampicin. A 58-year-old woman was admitted to our department because of high-grade fever with rigors, accompanied by abdominal and lumbar pain and laboratory evidence of acute haemolysis. She had been treated for brucellosis initially with doxycycline and streptomycin. Due to subsequent appearance of myositis, ciprofloxacin and rifampicin were added for treatment of localised brucellosis. After intravenous administration of rifampicin, the patient deteriorated significantly. After exclusion of other causes of haemolysis, autoimmune haemolytic anaemia related to rifampicin was established by strongly positive direct Coombs test. Drug withdrawal in conjunction with intravenous immune globulin and prednisolone resulted in resolution of haemolysis and no relapse in the ensuing 1-year period. Our case highlights the importance of recognising commonly administrative drugs as cause of haemolytic anaemia, that can often be life threatening.

Keywords: haematology (drugs and medicines); haematology (incl blood transfusion); unwanted effects / adverse reactions.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

References

    1. Garratty G. Immune hemolytic anemia caused by drugs. Expert Opin Drug Saf 2012;11:635–42. 10.1517/14740338.2012.678832 - DOI - PubMed
    1. Arndt PA, Garratty G. The changing spectrum of drug-induced immune hemolytic anemia. Semin Hematol 2005;42:137–44. 10.1053/j.seminhematol.2005.04.004 - DOI - PubMed
    1. Garratty G, Arndt PA. An update on drug-induced immune hemolytic anemia. Immunohematology 2007;23:105–19. - PubMed
    1. Broadberry RE, Farren TW, Bevin SV, et al. . Tazobactam-induced haemolytic anaemia, possibly caused by non-immunological adsorption of IgG onto patient’s red cells. Transfus Med 2004;14:53–7. 10.1111/j.0958-7578.2004.00481.x - DOI - PubMed
    1. Brucellosis. In Hellenic Society for Infectious Diseases and the Hellenic Center for Disease Control and Prevention guidelines for the diagnosis and management of infectious diseases. Hellenic Society for Infectious Diseases. 2nd edn Athens: Focus on Health Ltd, 2015:361–6.

Publication types

MeSH terms