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呋喃妥因所致自身免疫性肝炎和间质性肺病并存

Concomitant Nitrofurantoin-Induced Autoimmune Hepatitis and Interstitial Lung Disease.

作者信息

Carvalho de Matos Andreia, Pais Macedo Cristiane, Afonso Mendes Patrícia, Cipriano Maria Augusta, Paiva Artur, Simão Adélia

机构信息

Internal Medicine Department, Coimbra Hospital and University Center, Coimbra, Portugal.

University Clinic of Internal Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

出版信息

GE Port J Gastroenterol. 2021 Jun 30;29(4):273-279. doi: 10.1159/000516940. eCollection 2022 Jul.

Abstract

Antibiotics are known to cause adverse reactions, but multiple organ involvement associated with nonspecific symptoms can lead to a delay in diagnosis. A definitive correlation between each toxin and its effects is difficult to establish due to concomitant potential toxins in the circulation. This article highlights an uncommon case of concomitant nitrofurantoin-induced autoimmune hepatitis and lung fibrosis that fulfills the definitive clinical criteria for diagnosis, presenting histological, imagiological, and immunological evidence of nitrofurantoin-induced toxicity. It occurred in a 68-year-old woman with extended nitrofurantoin intake for urinary tract infection prophylaxis who presented with progressive exercise dyspnea and jaundice. Similar published cases are also reviewed in this article.

摘要

抗生素已知会引起不良反应,但多器官受累伴非特异性症状可能导致诊断延迟。由于循环中存在潜在的伴随毒素,很难确定每种毒素与其作用之间的明确关联。本文重点介绍了一例罕见的同时发生的呋喃妥因诱导的自身免疫性肝炎和肺纤维化病例,该病例符合明确的诊断临床标准,呈现了呋喃妥因诱导毒性的组织学、影像学和免疫学证据。患者为一名68岁女性,因预防尿路感染长期服用呋喃妥因,出现进行性运动性呼吸困难和黄疸。本文还回顾了类似的已发表病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d02c/9274943/11abde51652b/pjg-0029-0273-g01.jpg

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