Nitrofurantoin-Induced Hepatotoxicity Mediated by CD8+ T Cells

Kelly, Brendan D.; Heneghan, Michael A.; Bennani, Fadel; Connolly, Charles E.; O'Gorman, Thomas A.
May 1998
American Journal of Gastroenterology;May1998, Vol. 93 Issue 5, p819
Academic Journal
Case Study
Nitrofurantoin is a synthetic nitrofuran commonly used for the treatment and prophylaxis of urinary tract infections. We describe the case of a 75-yr-old woman who was taking nitrofurantoin as prophylaxis against recurrent urinary tract infections, and who subsequently developed pulmonary and hepatic toxicity. We postulate that a breakdown product of the drug or the drug itself complexed to an endogenous peptide is presented by the class I HLA antigen on the hepatocyte cell membrane, inducing cytotoxic T cell activation and subsequently, hepatocyte death.


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