Nitrofurantoin-induced chronic active hepatitis.
BACKGROUND
Nitrofurantoin is a commonly prescribed urinary antiseptic. Hepatic injury has been associated with its use.


OBJECTIVE
To present three patients in whom long-term exposure to the drug resulted in chronic active hepatitis; and to review the epidemiology, clinical immunology, histopathology, pathogenetic features and treatment of previously reported cases.


RESULTS
Withdrawing nitrofurantoin once the diagnosis was suspected did not lead to remission of the liver disease and glucocorticoids had to be administered. One patient died of liver failure.


CONCLUSIONS
Awareness of this unusual side effect of nitrofurantoin is important and caution should be taken before prescribing it. Over the past years new insight into the immune nature of this drug has emerged.
Amit
Guy
G
Department of Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
Cohen
Patrizia
P
Ackerman
Zvi
Z
D000368:Aged; D000892:Anti-Infective Agents, Urinary / Q000009:adverse effects*; D056487:Chemical and Drug Induced Liver Injury, Chronic / Q000201:enzymology / Q000503:physiopathology*; D017809:Fatal Outcome; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008111:Liver Function Tests; D008875:Middle Aged; D009582:Nitrofurantoin / Q000009:adverse effects*
D000892:Anti-Infective Agents, Urinary; D005938:Glucocorticoids; D009582:Nitrofurantoin