Acute Onset Nitrofurantoin-induced Autoimmune Hepatitis After Urinary Tract Infection Treatment

Overview

Journal Clin Case Rep

Date 2024 Jun 13

PMID 38868111

Authors

Ammad Javaid Chaudhary

Muhammad Zarrar Khan

Abdullah Sohail

Syed Murtaza Haider Zaidi

Eric Denha

Deepak Venkat

Affiliations

Soon will be listed here.

Abstract

Key Clinical Message: This case signifies the importance of recognizing DIAIH within the context of antibiotic therapy, especially in older adults and even shortly after common drug exposures for treating UTI.

Abstract: Various drugs can induce immune-mediated liver damage and in rare instances may lead to autoimmune hepatitis. Here we report an 84-year-old woman who developed autoimmune hepatitis less than 3 weeks after treatment for urinary tract infection with the antibiotic nitrofurantoin. She presented with jaundice, right upper quadrant abdominal pain, nausea, and vomiting. In the absence of a history of an autoimmune disorder or elevated liver enzymes in the past; elevated liver enzymes after a short course of Nitrofurantoin and the presence of smooth muscle antibodies strongly suggested autoimmune hepatitis, which was confirmed through biopsy sample analysis. The patient scored 7 points on the Naranjo adverse reaction probability scale. The patient's rapid recovery within 1 month of prednisone therapy supports the association of liver damage with nitrofurantoin use.

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