Journal of Yeungnam Medical Science

영남대 의대 학술지 편집위원회 (Yeungnam University College of Medicine, Yeungnam University Institute Medical Science)
권호 표지

애디슨병 환자에게 리팜핀 투여 후 발생한 급성 부신피질기능 저하증 1예

A Case of Rifampin-Induced Recurrent Adrenal Insufficiency During the Treatment of Pulmonary Tuberculosis in a Patient with Addison's Disease

  • 강종식 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 고광범 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 이재준 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 전성진 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 김민수 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 최광현 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 김선목 (울산대학교 의과대학 서울아산병원 내과학교실) ;
  • 이우제 (울산대학교 의과대학 서울아산병원 내과학교실)
  • Kang, Jong-Sik (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ko, Gwang-Beom (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Jae-June (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Min-Soo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jeon, Sung-Jin (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Gwang-Hyeon (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Sun-Mok (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Woo-Je (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 발행 : 2012.06.30
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초록

Adrenal insufficiency during the treatment of pulmonary tuberculosis is a troublesome condition and can at times be lifethreatening if untreated. Rifampin is one of the most widely prescribed anti-tuberculosis agents. Furthermore, rifampin has been known to be capable of affecting the metabolism of various medications, including glucocorticoids. In this paper, a case of recurrent adrenal insufficiency induced by rifampin during the treatment of pulmonary tuberculosis is reported. The patient was a 63-year-old man who was diagnosed with Addison's disease 17 years earlier and had been undergoing glucocorticoid replacement therapy. Five months before, the patient manifested pulmonary tuberculosis and was immediately given anti-tuberculosis medication that included rifampin. After one week of medication, general weakness and hyponatremia occurred. Despite the increased dose of the glucocorticoid medication, the adrenal insufficiency recurred many times. Since the substitution of levofloxacin for rifampin, the episodes of adrenal insufficiency have not recurred so far.

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