Pulmonary tuberculosis complicated by haemophagocytic syndrome and rifampicin-induced tubulointerstitial nephritis.

The benign, or infection-associated, haemophagocytic syndrome (IAHS) is a rare bone marrow disorder of macrophage cell proliferation diagnosed most commonly in immune compromised patients who develop herpes type viral infections (Risdall et al. 1979). It has also been reported in association with bacterial infections and rarely with mycobacterial infection (Chandra et al. 1975; Mamoharon & Catovsky 1981; Bultmann et al. 1982). Despite being potentially reversible it may produce a life-threatening pancytopenia (Seligman et al. 1972). We report a further case of the haemophagocytic syndrome associated with Mycobacterium tuberculosis in which thrombocytopenia was the predominant feature. There were unusual features in the clinical presentation and the patient's treatment and recovery were subsequently complicated by rifampicin-induced renal failure.