Introduction: Drugs can occasionally trigger the onset of autoimmune liver disease. Case presentation: Three Caucasian women (aged 65, 42 and 74 years old) who were receiving long-term nitrofurantoin as prophylaxis against recurrent urinary tract infections developed hepatitic liver disease. Serological auto-antibody profiles and liver histology appearances were consistent with autoimmune hepatitis. Two of the patients presented with jaundice, and one required a prolonged hospital admission for liver failure. In all three patients nitrofurantoin was withdrawn, and long-term immunosuppressive therapy with prednisolone and azathioprine or mycophenolate was given. The patients responded well, with liver biochemistry returning to normal within a few months. Conclusions: Although nitrofurantoin rarely causes autoimmune hepatitis, this antimicrobial is increasingly used as long-term prophylaxis against recurrent urinary tract infection. General practitioners and urologists who prescribe long-term nitrofurantoin therapy should be aware of this adverse effect.
CITATION STYLE
Appleyard, S., Saraswati, R., & Gorard, D. A. (2010). Autoimmune hepatitis triggered by nitrofurantoin: A case series. Journal of Medical Case Reports, 4(1). https://doi.org/10.1186/1752-1947-4-311
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