Nitrofurantoin-induced granulomatous hepatitis

Area of Science:

• Hepatology
• Pharmacology
• Toxicology

Background:

• Nitrofurantoin is a widely prescribed antibiotic for urinary tract infections.
• Previous literature has documented nitrofurantoin-induced liver injury (DILI), primarily manifesting as hepatocellular or cholestatic patterns.
• The spectrum of nitrofurantoin hepatotoxicity is not fully elucidated.

Observation:

• A case of a patient developing liver injury after nitrofurantoin treatment is presented.
• The patient exhibited clinical and biochemical features consistent with hepatitis.
• Histopathological examination revealed granulomatous inflammation in the liver.

Findings:

• The liver injury was attributed to nitrofurantoin based on temporal association and exclusion of other causes.
• The histological pattern of granulomatous hepatitis is a less common presentation of nitrofurantoin DILI.
• This finding expands the known histopathological spectrum of nitrofurantoin-induced liver injury.

Implications:

• Clinicians should consider nitrofurantoin as a potential cause of granulomatous hepatitis.
• Early recognition and discontinuation of the drug are crucial for managing nitrofurantoin-induced liver injury.
• Further research may be warranted to understand the mechanisms underlying this specific presentation of DILI.