Autoimmune Hepatitis Induced by Nitrofurantoin. The Importance of the Autoantibodies for an Early Diagnosis of Immune Disease

Overview

Journal Clin Pract

Publisher MDPI

Specialty General Medicine

Date 2014 Apr 26

PMID 24765482

Citations 7

Authors

Jagannath M Sherigar

Richard Fazio

Minsheng Zuang

Edward Arsura

Affiliations

Soon will be listed here.

Abstract

Nitrofurantoin has been in use since 1953 as an effective agent for the prevention of recurrent urinary tract infection. It is associated with a wide range of adverse drug reactions. Chronic active hepatitis has increasingly been observed and many cases have been reported with case fatalities. We present a case of nitrofurantoin induced chronic active hepatitis and briefly review the serology and clinico pathological features of 57 similar cases reported in English literature. The consistent presence of antinuclear antibody, anti smooth muscle antibody, elevated immunoglobulin and pathological feature suggests an immunologic mechanism. Complete recovery is possible in most cases if medication is discontinued in time. Steroids may play a role in management if no improvement occurs despite discontinuation of medication. We suggest all patients who are on prolonged nitrofurantoin therapy be followed up with anti nuclear antibody, anti smooth muscle antibody, serum immunoglobulin and hepatic panel every three months.

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