The clinical and biochemical findings on two patients who developed hepatic injury while taking nitrofurantoin are described. In both patients the main biochemical abnormality was elevation of serum transaminase values. Clinical and biochemical findings reverted to normal after with-drawal of medication. Nitrofurantoin was readministered to one patient, and hypertransaminasemia recurred. The light-microscopic and ultrastructural findings from hepatic biopsy specimens from both patients were those of a predominantly hepatocellular type of injury. Different pathogenic mechanisms are postulated for the hepatic injury in the two patients. Six previously reported cases are compared and contrasted with the present patients.
This investigation was supported in part by a research contract, Project Number 3A061102B71R-02, from the Medical Research and Development Command, US Army, Washington, DC.
The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Departments of the Army or Defense.