[Liver cirrhosis due to chronic use of nitrofurantoin].
A 74-year-old woman was admitted with jaundice. She was suffering from generalised liver failure with a highly prolonged prothrombin time, a low albumin level and ascites. Further anamnesis revealed that she had been taking nitrofurantoin as a prophylactic agent for recurrent urinary tract infections every day for 5 years. Because of the indications for liver damage due to nitrofurantoin, the drug was discontinued immediately on admission. After withdrawal of nitrofurantoin there was a very gradual clinical and biochemical improvement. Liver biopsies to confirm the diagnosis revealed extensive liver damage with cirrhosis such as may be seen following long-term use of nitrofurantoin. Nitrofurantoin should be prescribed with caution as a prophylactic agent in elderly women and patients with renal dysfunction because the risk of liver damage as a serious side effect of nitrofurantoin is greatly increased in these patients.
Locatie Sophia, afd. Interne Geneeskunde, Isala Klinieken, Zwolle. frankevolbeda@hotmail.com
F
F
Volbeda
A M
AM
Jonker
J
J
Vecht
P H
PH
Groeneveld
D000368:Aged; D000892:Anti-Infective Agents, Urinary / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000473:pathology; D008103:Liver Cirrhosis / Q000139:chemically induced* / Q000175:diagnosis; D009582:Nitrofurantoin / Q000009:adverse effects* / Q000627:therapeutic use; D013997:Time Factors; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000517:prevention & control*
D000892:Anti-Infective Agents, Urinary; D009582:Nitrofurantoin