02023nas a2200325   4500000000100000008004100001260007600042653001900118653000900137653002200146653004300168653003700211653001100248653001000259653001100269653001600280653001200296653001300308653001300321100001200334700002300346700001600369700001600385700001100401245009600412300001000508490000700518520115800525022001401683       2012                            d  c2012 FebbAmerican Society of Tropical Medicine and HygieneaNorthbrook10aAbdominal pain10aAged10aAnemia, Hemolytic10aDisseminated Intravascular Coagulation10aDose-Response Relationship, Drug10aFemale10aFever10aHumans10aHypotension10aleprosy10aRifampin10aVomiting1 aHavey T1 aCserti-Gazdewich C1 aSholzberg M1 aKeystone JS1 aGold W00aRecurrent disseminated intravascular coagulation caused by intermittent dosing of rifampin.  a264-70 v863 a<p>Daily rifampin therapy is associated with minimal adverse effects, but administration on an intermittent or interrupted basis has been associated with severe immunoallergic reactions such as hemolytic anemia, acute renal failure, and disseminated intravascular coagulation. We describe a patient with Mycobacterium leprae infection who experienced recurrent episodes of disseminated intravascular coagulation after intermittent exposures to rifampin, and review eight previously reported cases of rifampin-associated disseminated intravascular coagulation. In six (75%) cases, previous exposure to rifampin was reported and seven (87.5%) patients were receiving the medication on an intermittent or interrupted basis. Clinical features of rifampin-associated disseminated intravascular coagulation included fever, hypotension, abdominal pain, and vomiting within hours of ingestion. Average time to reaction was 3-6 doses if rifampin was being administered on a monthly schedule. Three (37.5%) of eight reported cases were fatal. A complete history of previous exposure to rifampin is recommended before intermittent therapy with this medication.</p>  a1476-1645