Appleyard Sally, Saraswati Ruma, Gorard David A
Wycombe Hospital, Queen Alexandra Road, High Wycombe, Bucks HP11 2TT, UK.
J Med Case Rep. 2010 Sep 23;4:311. doi: 10.1186/1752-1947-4-311.
Drugs can occasionally trigger the onset of autoimmune liver disease.
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 In all three patients nitrofurantoin was withdrawn, and long-term immunosuppressive therapy with prednisolone and azathioprine or mycophenolate was given.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.
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.
药物偶尔会引发自身免疫性肝病。
三名接受长期呋喃妥因预防复发性尿路感染的白种女性（年龄分别为65岁、42岁和74岁）出现了肝炎性肝病。血清学自身抗体谱和肝脏组织学表现与自身免疫性肝炎一致。其中两名患者出现黄疸，一名因肝衰竭需要长期住院治疗。在所有三名患者中，均停用了呋喃妥因，并给予泼尼松龙和硫唑嘌呤或霉酚酸酯进行长期免疫抑制治疗。患者反应良好，肝功能在几个月内恢复正常。
尽管呋喃妥因很少引起自身免疫性肝炎，但这种抗菌药物越来越多地被用于长期预防复发性尿路感染。开具长期呋喃妥因治疗的全科医生和泌尿科医生应意识到这种不良反应。
