Abstract: Objective To summarize the epidemiology, clinical features and prognostic outcomes of rifampicin-induced hemolytic anaemia, and to provide data for the prevention and treatment of rifampicin-induced hemolytic anaemia. Methods A systematic evaluation was conducted by searching such databases as Pubmed, Web of Science, Proquest, Ovid, China Knowledge, Wanfang data, Wipo, and SinoMed. Clinical cases with confirmed diagnosis of rifampicin-induced haemolytic anaemia reported before December 31, 2023 were collected. Results A total of 62 pieces of literature were included in the evaluation, consisting of 45 in Chinese and 17 in English. Among the 69 patients with rifampicin-induced haemolytic anaemia, the age ranged from 7 months to 80 years. There were 35 male cases (50.72%) and 34 female ones (49.28%). Forty-nine cases were reported in China and the rest abroad. Haemolytic anaemia occurred in 42 cases (60.87%) after the first dose of rifampicin, in 24 cases (34.78%) after intermittent use of the drug, but the time of onset was unknown in three cases (4.35%). Common clinical manifestations included fever, chills, nausea, and vomiting, often accompanied by elevated white blood cells, liver aminotransferases, bilirubin, creatinine, and a significant decrease in haemoglobin. Treatments mainly involved immediate drug withdrawal, oxygenation, fluid replacement, maintenance of water and electrolyte acid-base balance, diuresis, alkalinisation of urine, application of hormones, anti-allergic drugs, hepatoprotective drugs, blood transfusion, haemodialysis, plasma exchange, and peritoneal dialysis. After treatment, 52 patients (75.36%) showed improvement and were discharged, 10 patients (14.49%) died, and the outcome was unknown in 7 patients (10.14%). Conclusion Rifampicin-induced haemolytic anaemia has been reported in recent years and can strike patients of any age, and intermittent use of rifampicin is more likely to result in haemolytic anaemia. The early symptoms of haemolytic anaemia are mostly influenza symptoms and gastrointestinal discomfort. Prompt treatment usually has a good prognosis, but the disease may progress rapidly and may to death in severe cases.

Key words: rifampicin, haemolytic anaemia, haemolytic uremic syndrome, adverse drug reaction, case report, systematic review