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Related Experiment Videos

Anicteric liver damage during nitrofurantoin medication.

H Klemola, O Penttilä, L Runeberg

    Scandinavian Journal of Gastroenterology
    |January 1, 1975
    PubMed
    Summary
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    Nitrofurantoin can cause liver injury, specifically anicteric hepatitis, in susceptible individuals. Drug withdrawal normalized liver enzymes, but other markers persisted, indicating potential long-term effects.

    Area of Science:

    • Hepatology
    • Clinical Pharmacology
    • Toxicology

    Background:

    • Nitrofurantoin is a commonly prescribed antibiotic.
    • Drug-induced liver injury (DILI) is a significant concern.
    • Anicteric hepatitis, or jaundice-free liver inflammation, can be a manifestation of DILI.

    Purpose of the Study:

    • To investigate the relationship between nitrofurantoin use and the development of anicteric hepatitis.
    • To characterize the clinical, biochemical, and histological features of nitrofurantoin-induced liver injury.
    • To assess the reversibility of liver damage after drug withdrawal.

    Main Methods:

    • Case series describing four patients with suspected nitrofurantoin-induced liver injury.
    • Clinical assessment including serum transaminase levels and hypergammaglobulinaemia.

    Related Experiment Videos

  • Liver biopsy analysis for histological changes.
  • Assessment of albumin-IgG complexes.
  • Drug re-challenge in one patient.

    • Main Results:

    • All four patients presented with elevated serum transaminases and hypergammaglobulinaemia.
    • Liver biopsies were suggestive of chronic active hepatitis, with three showing cirrhotic features.
    • Two patients had circulating albumin-IgG complexes.
    • Serum transaminases normalized within weeks of nitrofurantoin withdrawal.
    • Hypergammaglobulinaemia and biopsy findings remained largely unchanged for 2-6 months.
    • Re-challenge with nitrofurantoin led to recurrent elevation of serum transaminases.

    Conclusions:

    • Nitrofurantoin can be associated with anicteric hepatitis and chronic liver injury.
    • Liver enzyme normalization occurs after drug cessation, but histological changes may persist.
    • The potential for long-term liver damage and the utility of drug re-challenge as a diagnostic tool are highlighted.