Nitrofurantoin-induced acute liver damage in pregnancy.
This article presents a rare case of acute toxic hepatitis in thirty-one-year old primigravida. In the 36th week of gestation, the patient was introduced nitrofurantoin 100 mg a day due to symptoms of dysuria and enterococcus isolated from urine culture. After induced delivery at term because of hypertension, repeated laboratory findings showed increased aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and negative hepatitis C and B markers. The patient was subicteric at the time. Coagulation and complete blood count values were within the normal range. Nitrofurantoin therapy was discontinued. Abdominal ultrasound was normal with the exception of a slight hepatomegaly without any lesions, focal or diffuse. Given that discontinuation of nitrofurantoin and introduction of methylprednisolon therapy significantly lowered liver enzyme levels, restoring most of them to normal, we concluded that this was probably the case of toxic liver damage caused by nitrofurantoin.
Department of Obstetrics and Gynaecology, Sveti Duh General Hospital Zagreb, Zagreb, Croatia.
Alenka
A
Aksamija
Gordana
G
Horvat
Dubravko
D
Habek
Damir
D
Zalac
Eva
E
Jendris
D000208:Acute Disease; D000328:Adult; D000892:Anti-Infective Agents, Urinary / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D005260:Female; D006801:Humans; D009582:Nitrofurantoin / Q000009:adverse effects*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D014552:Urinary Tract Infections / Q000188:drug therapy
D000892:Anti-Infective Agents, Urinary; D009582:Nitrofurantoin