Rifampicin-Induced Vasculitis Combined with Thrombocytopenia-Unusual Side Effects in a Patient Receiving Anti-tuberculosis Chemotherapy

Rifampicin引起的血管炎合併血小板低下症－病例報告

江雅惠(Ya-Hui Chiang) ； 林鴻欣(Horng-Shin Lin) ； 張菡(Han Chang) ； 曹昌堯(Chang-Yao Tsao)

《胸腔醫學》 26卷1期 (2011/02) Pp. 13-18

https://doi.org/10.29806/TM.201102.0003

摘要

Rifampicin引起血管炎合併血小板低下症、噬伊紅性白血球過多症並不常見。這是一個66歲男性在服用抗肺結核藥物4個月後，病人開始出現發燒的症狀，並在四肢、腹部出現紫斑。之後，血液檢驗出現血小板低下症、噬伊紅性白血球過多症等異常現象。皮膚切片在免疫螢光染色下顯現IgM和C3沉積於血管 壁，因此，Leukocytolastic vasculitis（LCV）確診。在停用Rifampicin和使用類固醇之後，病人的症狀消失，並且血小板和噬伊紅性白血球的數值均回復到正常值範圍。

關鍵字

抗肺結核藥物 ； 血管炎 ； 血小板低下症

並列摘要

We reported the case of a 66-year-old male patient with active pulmonary tuberculosis. He suffered from low-grad fever and palpable confluent purpaura on the lower limbs and abdomen at 4 months after anti-tuberculous chemotherapy. Thrombocytopenia and eosinophilia were also noted. Leukocytoclastic vasculitis was diagnosed by skin biopsy, which revealed a granular deposition of IgM and C3 at the vascular wall in the superficial dermis, using direct immunofluorescence staining. His skin lesions and fever subsided quickly and the eosinophil and platelet counts returned to normal ranges after rifampicin and corticosteroid treatments were stopped.

並列關鍵字

rifampicin ； vasculitis ； thrombocytopenia