Rifampicin-induced nonresponsiveness to corticosteroid treatment in systemic lupus erythematosus: A case report

Abstract

Accelerated inactivation of corticosteroids following rifampicin therapy has been She was transfered to our hospital in August 1981. On admission, she had a few skin obtained by transbronchial lung biopsy from the left lung showed mild interstitial thickening of alveoli with mononuclear cell infiltration. Prednisolone was increased from daily dose of 5mg to 80 mg and 450 mg of rifampicin, 1,000mg of ethambutol were added, but no response was obtained. In December 1981, prednisolone was altered to equivalent dose of betamethasone but minimal improvement was observed. After quitting rifampicin on January 1982, dramatic improvement in symptoms, laboratory data and chest roentgenogram was achieved. Although pharmacokinetic studies were not performed, we feel that the circumstantial evidence suggests strongly to increased metabolism of prednisolone by rifampicin-induced microsomal enzymes. © 1984, JAPANESE SOCIETY FOR TUBERCULOSIS. All rights reserved.