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Am J Gastroenterol. 1998 May;93(5):819-21.

Nitrofurantoin-induced hepatotoxicity mediated by CD8+ T cells.

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Department of Gastroenterology, University College Hospital, Galway, Ireland.


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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