Rifampin-induced vitamin K deficiency coagulopathy in a patient with brucellosis and rheumatoid arthritis: A clinical case report

Coagulopathy as a reversible dose-dependent side effect of rifampin is rarely observed in patient on rifampin in associate to inducing vitamin K deficiency. We reported a middle-aged man on a brucellosis three-drug regimen (including rifampin) who was admitted to the hospital due to a rheumatoid arthritis flare-up with increased partial thrombin time and international normalized ratio. Abnormal coagulation tests were discovered as an unintentional finding in the absence of clinical signs of bleeding. However, the coagulation tests returned to normal in 48 hours by withdrawing rifampin and administering 2.5 mg of oral vitamin K. The patient was discharged with a new brucellosis regimen including doxycycline and trimethoprim/sulfamethoxazole.