Nitrofurantoin-induced immune-mediated lung and liver disease
Introduction. Nitrofurantoin, a furan derivative, introduced in the fifties has widely been used as an effective agent for the treatment and prevention of urinary tract infections (UTI). Spectrum of adverse reactions to nitrofurantoin is wide, ranging from eosinophilic interstitial lung disease,...
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Military Health Department, Ministry of Defance, Serbia
2012-01-01
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doaj-5d108b3aed8f46f886d8c951e780827c2020-11-24T23:42:41ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502012-01-0169653654010.2298/VSP1206536MNitrofurantoin-induced immune-mediated lung and liver diseaseMilić RadePlavec GoranTufegdžić IvanaTomić IlijaŠarac SanjaLončarević OliveraIntroduction. Nitrofurantoin, a furan derivative, introduced in the fifties has widely been used as an effective agent for the treatment and prevention of urinary tract infections (UTI). Spectrum of adverse reactions to nitrofurantoin is wide, ranging from eosinophilic interstitial lung disease, acute hepatitis and granulomatous reaction, to the chronic active hepatitis, a very rare adverse effect, that can lead to cirrhosis and death. Case report. We presented a 55-year-old female patient with eosinophilic interstitial lung disease, severe chronic active hepatitis and several other immune- mediated multisystemic manifestations of prolonged exposure to nitrofurantoin because of the recurrent UTI caused by Escherichia coli. We estimated typical radiographic and laboratory disturbances, also restrictive ventilatory changes, severe reduction of carbon monoxide diffusion capacity and abnormal liver function tests. Lymphocytic-eosinophylic alveolitis was consistent with druginduced reaction. Hepatitis was confirmed by liver biopsy. After withdrawal of nitrofurantoin and application of high dose of glicocorticosteroids, prompt clinical and laboratory recovery was achieved. Conclusion. Adverse drug reactions should be considered in patients with concomitant lung and liver disease. The mainstay of treatment is drug withdrawal and the use of immunosuppressive drugs in severe cases. Consideration should be given to monitor lung and liver function tests during long term nitrofurantoin therapy.http://www.doiserbia.nb.rs/img/doi/0042-8450/2012/0042-84501206536M.pdfnitrofurantoinurinary tract infectionsdrug toxicityimmunologic factorshepatitispneumonia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Milić Rade Plavec Goran Tufegdžić Ivana Tomić Ilija Šarac Sanja Lončarević Olivera |
spellingShingle |
Milić Rade Plavec Goran Tufegdžić Ivana Tomić Ilija Šarac Sanja Lončarević Olivera Nitrofurantoin-induced immune-mediated lung and liver disease Vojnosanitetski Pregled nitrofurantoin urinary tract infections drug toxicity immunologic factors hepatitis pneumonia |
author_facet |
Milić Rade Plavec Goran Tufegdžić Ivana Tomić Ilija Šarac Sanja Lončarević Olivera |
author_sort |
Milić Rade |
title |
Nitrofurantoin-induced immune-mediated lung and liver disease |
title_short |
Nitrofurantoin-induced immune-mediated lung and liver disease |
title_full |
Nitrofurantoin-induced immune-mediated lung and liver disease |
title_fullStr |
Nitrofurantoin-induced immune-mediated lung and liver disease |
title_full_unstemmed |
Nitrofurantoin-induced immune-mediated lung and liver disease |
title_sort |
nitrofurantoin-induced immune-mediated lung and liver disease |
publisher |
Military Health Department, Ministry of Defance, Serbia |
series |
Vojnosanitetski Pregled |
issn |
0042-8450 |
publishDate |
2012-01-01 |
description |
Introduction. Nitrofurantoin, a furan derivative, introduced in the fifties has widely been used as an effective agent for the treatment and prevention of urinary tract infections (UTI). Spectrum of adverse reactions to nitrofurantoin is wide, ranging from eosinophilic interstitial lung disease, acute hepatitis and granulomatous reaction, to the chronic active hepatitis, a very rare adverse effect, that can lead to cirrhosis and death. Case report. We presented a 55-year-old female patient with eosinophilic interstitial lung disease, severe chronic active hepatitis and several other immune- mediated multisystemic manifestations of prolonged exposure to nitrofurantoin because of the recurrent UTI caused by Escherichia coli. We estimated typical radiographic and laboratory disturbances, also restrictive ventilatory changes, severe reduction of carbon monoxide diffusion capacity and abnormal liver function tests. Lymphocytic-eosinophylic alveolitis was consistent with druginduced reaction. Hepatitis was confirmed by liver biopsy. After withdrawal of nitrofurantoin and application of high dose of glicocorticosteroids, prompt clinical and laboratory recovery was achieved. Conclusion. Adverse drug reactions should be considered in patients with concomitant lung and liver disease. The mainstay of treatment is drug withdrawal and the use of immunosuppressive drugs in severe cases. Consideration should be given to monitor lung and liver function tests during long term nitrofurantoin therapy. |
topic |
nitrofurantoin urinary tract infections drug toxicity immunologic factors hepatitis pneumonia |
url |
http://www.doiserbia.nb.rs/img/doi/0042-8450/2012/0042-84501206536M.pdf |
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