There are a limited number of pathological responses to noxious stimuli, including drugs, and drug-induced (iatrogenic) disease may be difficult to distinguish from other causes. We describe the case of a woman who had two different serious reactions in association with two courses of the antibiotic nitrofurantoin given 16 On specific questioning about whether she might be taking any medications, particularly for prevention of cystitis, she recalled that she had been prescribed by her general practitioner a urinary, 'antiseptic' tablet which she had taken at night for more than a year but she had not considered it to be a drug. It was subsequently identified as nitrofurantoin 50 mg. A working diagnosis of nitrofurantoininduced interstitial pulmonary fibrosis was made, the drug was stopped and she improved gradually such that eight weeks later her tCO had risen to 16.93 and her chest X-ray is shown in the figure (B)
Using an immunoperoxidase staining technique for muramidase (lysozyme)-containing cells in liver biopsies, the Kupffer cell population has been compared with the isotope liver scan abnormalities in 43 patients with various liver diseases. A significantly greater degree of scintigraphic abnormality was seen in cirrhotics compared with non-cirrhotics using both a visually assessed scan scoring technique (p < 0.001) and computer-generated spleen-to-liver (S-L) relative activity ratios (p
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