Nitrofurantoin-Induced Immune-Mediated Lung and Liver Disease
作者:
A. Schattner,
J. Von der Walde,
N. Kozak,
N. Sokolovskaya,
H. Knobler,
期刊:
The American Journal of the Medical Sciences
(OVID Available online 1999)
卷期:
Volume 317,
issue 5
页码: 336-336
ISSN:0002-9629
年代: 1999
出版商: OVID
关键词: Nitrofurantoin;Toxicity nitrofurantoin;Adverse drug reaction interstitial lung disease;Drug-induced liver disease;Drug-induced chronic active hepatitis
数据来源: OVID
摘要:
A 60-year-old woman with multiple sclerosis and recurrent urinary tract infections (UTI) was evaluated for the recent onset of a dry cough, dyspnea on exertion, and jaundice. Investigation demonstrated interstitial lung disease with bilateral infiltrates and unilateral effusion, as well as a severe chronic active hepatitis with marked fibrosis. Other notable features were positive antinuclear antibodies and anti-smooth-muscle antibodies and the absence of any possible cause except for nitrofurantoin treatment (Macrodantin, 100 mg/day), which the patient had been taking for the previous 3 years as a prophylactic measure against UTI. The patient died of pneumococcal septicemia less than 30 days after presentation. Pulmonary or hepatic injury caused by nitrofurantoin treatment is rare; their combined occurrence is hardly ever described. Combined drug-induced pulmonary and hepatic toxicity is reviewed and should be considered early in the differential diagnosis to allow reversibility and avoid serious outcomes.
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