Chronic active hepatitis induced by nitrofurantoin1
Thomas L. Young, M.D.
Edgar Achkar, M.D., F.A.C.P.
Ralph Tuthill, M.D.
D. Roy Ferguson, M.D., F.A.C.P.
In 2 women who had received nitrofurantoin for two to five years, autoimmune chronic hepatitis developed, leading to severe hepatic necrosis and, in one case, cirrhosis. Treatment consisted of withdrawal and, in one case, institution of steroids and azathioprine. Both patients demonstrated symptomatic and biochemical improvement despite chronic histological changes. Nitrofurantoin is a cause of “lupoid” chronic active hepatitis which could lead to severe and irreversible histological changes.