Acute tubulointerstitial nephritis induced by rifampin 
following hair transplantation: a case report

Kalani, Navid; Rahmanian, Sara

Volume 83, Issue 10 (January 2025) Tehran Univ Med J. 2025, 83(10): 743-747 | Back to browse issues page

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Kalani N, Rahmanian S. Acute tubulointerstitial nephritis induced by rifampin following hair transplantation: a case report. Tehran Univ Med J. 2025; 83 (10) :743-747
URL: http://tumj.tums.ac.ir/article-1-13886-en.html

Acute tubulointerstitial nephritis induced by rifampin following hair transplantation: a case report

Navid Kalani¹, Sara Rahmanian ^*²

1- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran.
2- Department of Nephrology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran. , srahmanian@gmail.com

Abstract: (22 Views)

Background: Acute tubulointerstitial nephritis (ATIN) is a rare but potentially reversible cause of Acute kidney injury (AKI), most commonly triggered by an immune-mediated reaction to medications. Rifampin is a well-recognized culprit in this adverse reaction; however, its occurrence following non-surgical interventions such as hair transplantation is exceedingly uncommon. Given the rarity of reported ATIN cases associated with rifampin use after hair transplant, we present this case to highlight the diagnostic and therapeutic approach in a patient with this clinical presentation, emphasizing the importance of early recognition and timely intervention in similar scenarios.
Case Presentation: A 38-year-old male with no history of systemic illness or chronic medication use presented to the hospital approximately 50 days after undergoing a hair transplantation procedure. He complained of weakness, malaise, nausea, and vomiting. Laboratory evaluation revealed markedly elevated serum urea and creatinine levels (BUN: 86 mg/dL, Cr: 11.4 mg/dL). The patient had taken rifampin during the week prior to symptom onset. A kidney biopsy demonstrated findings consistent with acute tubular injury and tubulointerstitial nephritis characterized by mononuclear cell infiltration and a few eosinophils, supporting the diagnosis of drug-induced ATIN. Management consisted of rifampin discontinuation and initiation of corticosteroid therapy, which led to gradual improvement in renal function and cessation of hemodialysis within two weeks.
Conclusion: Acute tubulointerstitial nephritis (ATIN) is a reversible cause of acute kidney injury that can occur as an adverse reaction to medications. Although rifampin is widely used as an antibiotic, it can trigger an immune response and inflammation of the renal tubulointerstitium in susceptible patients. Early diagnosis, withdrawal of the offending agent, and prompt initiation of corticosteroid therapy play a critical role in preventing progression to end-stage renal disease and avoiding long-term dialysis dependence. This case report underscores the importance of a thorough medication history in patients presenting with acute kidney injury, even when the drug appears harmless or is prescribed in an unexpected context such as following a hair transplant.

Keywords: acute tubulointerstitial nephritis, acute interstitial nephritis, acute kidney injury, corticosteroid, drug-induced nephritis, hair transplantation, rifampin.

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Type of Study: Case Report |