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We discuss the epidemiology, pathophysiology and management of rifampicin induced shock, concluding that clinicians should be aware of this rare, but potential adverse effect, and be aware that adverse reactions to rifampicin are more frequent during re-exposure or longer dosing interval regimes. The evidence for desensitisation following such a reaction is lacking and this approach is not currently recommended. We would suggest close collaboration between specialties prescribing immunosuppression and the tuberculosis team when LTBI treatment is required after a reaction, with patient involvement to discuss the risks and benefits of treatment options.<\/jats:p>","DOI":"10.1136\/bcr-2019-232117","type":"journal-article","created":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T04:35:11Z","timestamp":1580704511000},"page":"e232117","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Rifampicin induced shock during re-exposure for treatment of latent tuberculosis"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2912-0594","authenticated-orcid":false,"given":"Christopher Francis","family":"Harlow","sequence":"first","affiliation":[{"name":"Department of Chest and Allergy, St Mary\u2019s Hospital, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamilah","family":"Meghji","sequence":"additional","affiliation":[{"name":"Department of Chest and Allergy, St Mary\u2019s Hospital, Imperial College Healthcare NHS Trust, London, UK"},{"name":"Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Chest and Allergy, St Mary\u2019s Hospital, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Chest and Allergy, St Mary\u2019s Hospital, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onn Min","family":"Kon","sequence":"additional","affiliation":[{"name":"Department of Chest and Allergy, St Mary\u2019s Hospital, Imperial College Healthcare NHS Trust, London, UK"},{"name":"National Heart and Lung Institute, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,2,2]]},"reference":[{"key":"2025082708461079000_13.1.e232117.1","unstructured":"NICE guidelines . 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