Thrombotic Microangiopathy After Kidney Transplantation Associated With Rifampicin: A Case Report.

Thrombotic microangiopathy (TMA) is a severe complication, particularly after kidney transplantation (KT), and is associated with significant morbidity, mortality and graft loss. Rifampicin (RIF), although rarely reported, has relevant interactions and may act as an additional trigger capable of precipitating TMA in susceptible patients. Diagnosis requires a high index of suspicion, exclusion of alternative causes and thorough investigation. Considering its prognostic impact on both graft and patient outcomes, identifying RIF as a potential causative agent is essential to guide clinical management, with immediate drug withdrawal being the most appropriate intervention. This case report aims to describe a case of TMA after KT associated with RIF use, given its clinical relevance and the scarcity of available reports.