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11:36
Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms
Published on: May 29, 2020
Autoimmune hepatitis triggered by nitrofurantoin: a case series
Sally Appleyard1, Ruma Saraswati, David A Gorard
1Wycombe Hospital, Queen Alexandra Road, High Wycombe, Bucks HP11 2TT, UK. david.gorard@buckshosp.nhs.uk.
Journal of Medical Case Reports
|September 25, 2010
Summary
Nitrofurantoin, an antibiotic for urinary tract infections, can rarely trigger autoimmune hepatitis. Prompt withdrawal and immunosuppressive treatment led to recovery in three patients, highlighting the need for physician awareness.
Area of Science:
- Hepatology
- Autoimmune Diseases
- Pharmacology
Background:
- Drug-induced liver injury is a recognized clinical concern.
- Autoimmune liver diseases can be idiopathic or triggered by external factors.
Purpose of the Study:
- To report cases of autoimmune hepatitis potentially induced by nitrofurantoin.
- To alert clinicians to this rare but serious adverse effect of a commonly prescribed antibiotic.
Main Methods:
- Case series of three patients presenting with hepatitic liver disease.
- Clinical presentation, serological markers, liver histology, and treatment response were analyzed.
- Nitrofurantoin withdrawal and immunosuppressive therapy (prednisolone, azathioprine/mycophenolate) were administered.
Main Results:
- Three women on long-term nitrofurantoin prophylaxis developed autoimmune hepatitis.
- Two patients experienced jaundice; one required hospitalization for liver failure.
- All patients improved with drug cessation and immunosuppression, normalizing liver biochemistry within months.
Conclusions:
- Nitrofurantoin can rarely induce autoimmune hepatitis.
- Increased use of nitrofurantoin for recurrent urinary tract infections necessitates awareness of this potential adverse effect.
- Physicians should consider nitrofurantoin as a potential cause in patients developing autoimmune hepatitis.
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