Subacute Pulmonary Infiltration Due to Nitrofurantoin

Sollaccio, Peter A.; Ribaudo, Charles A.; Grace, William J.

doi:10.7326/0003-4819-65-6-1284

Cited by 38 publications

(9 citation statements)

References 6 publications

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“…In every case there existed leucocytosis, uppermost 25.000/mm i with high neutrophilia, uppermost 95 per cent, and often more or less pronuonced eosinophilia. In several cases, however, eosinophilia was lacking (4, 10, II, 17,18). Erythrocyte sedimentation rate/1 hour is usually normal, but in the case here clearly increased.…”

Section: Discussionmentioning

confidence: 55%

Pleuro‐pulmonary Allergic Reaction to Nitrofurantoin

Heijer¹

1970

Allergy

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Nitrofurantoin (Furadantin) can create two kinds of sideeffects: i) toxic; 2) allergic.Slight to moderate side-effects of both kinds are quite common; severe side-effects, however, are rare. The most serious toxic side-effect is polyneuropathy caused by a dose too large in relation to the patient's renal function. The most serious side-effect of the allergic type is a syndrome, unique for nitrofurantoin, whose main effects are symptoms in the lungs. So far about 30 cases with acute and 6 with chronic pulmonary reactions have been described (20, 15). However, further cases are known and it is not unlikely that this allergic reaction occurs more commonly than the above-mentioned numbers indicate. CASE REPORTThe case related here is a woman, aged 37, Para 3. Since the beginning of the 1950's she has been treated with sulfonamides on several occasions, for what was believed to be cystitis. Towards the end of her latest pregnancy in the spring of 1968 she suffered several attacks similar to those caused by renal calculi. Because of this, after delivery urography was carried out, and this showed irregular calyces and minor calcifications bilaterally, believed to be signs of earlier pyelonephritis. The patient had no fever, urine cultures gave negative results, erjfthrocyte sedimentation rate/i hour was 10 mm and white blood corpuscles 3000/mm' with 57 per cent polymorphonuclear cells. On September 9/68 long-term therapy with nitrofurantoin tablets in the relatively small dose of 50 mg X 3 was introduced as a safety measure. After a week's treatment the patient's temperature rose suddenly to 39.8° C, as can be seen from the diagram. At the same time she experienced general pain in her body which she localised in her joints, shivering chills, a stitch on deep breathing, manifest dyspnea and

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Section: Discussionmentioning

confidence: 55%

Pleuro‐pulmonary Allergic Reaction to Nitrofurantoin

Heijer¹

1970

Allergy

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“…In 1966 Sollaccio et al (19) drew attention toacase of subacute pulmonary infiltrates caused by nitrofurantoin. Their patient had taken nitrofurantoin daily for one year and symptoms had been present for at least one month.…”

Section: Discussionmentioning

confidence: 99%

LUPUS‐LIKE SYNDROME ASSOCIATED WITH PULMONARY REACTION TO NITROFURANTOIN: Report of Three Cases

Selroos

Edgren

1975

Journal of Internal Medicine

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A systemic lupus erythematosus‐like syndrome developed simultaneously with pulmonary reactions of the chronic type in three female patients after treatment with nitrofurantoin for 12, 27 and 38 months, respectively. The syndrome was characterized by elevated ESR, polyclonal hypergammaglobulinemia, the presence of IgG anti‐nuclear antibodies and a positive latex‐fixation test. Two patients had severe arthralgia and one of them peripheral lymphadenopathy. Pleural effusion and a chronic active hepatitis were present in the third patient, in whom interstitial cystitis also developed. All signs and symptoms of the lupus‐like syndrome disappeared, without corticosteroid or other medication, when nitrofurantoin was omitted. The diminution of pulmonary infiltrates and the reversal of interstitial cystitis also appeared to be directly related to cessation of nitrofurantoin therapy. Our findings indicate that long‐term medication with nitrofurantoin may cause, in addition to pulmonary changes, a simultaneous lupus‐like syndrome. Our data also raise the possibility that interstitial cystitis may occur as an adverse reaction to nitrofurantoin therapy.

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“…Long-term nitrofurantoin has been implicated as a cause of chronic interstitial lung disease (Murray and Kronenberg, 1965;David, Andersen, and Stickler, 1968) and may produce subacute pulmonary involvement (Sollaccio, Ribaudo, and Grace, 1966). This paper reports the acute changes in lung function produced in a patient with hypersensitivity to nitrofurantoin, and the results give some indication of the type of reaction in the lungs.…”

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confidence: 96%

Acute pulmonary reaction to nitrofurantoin

Pinerua

Hartnett

1974

Thorax

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. Acute pulmonary reaction to nitrofurantoin. Acute pulmonary reaction to nitrofurantoin is a rare complication of a commonly used drug. This report of such a reaction presents studies of pulmonary function more detailed than are so far available. Studies made nine days after the drug had been withdrawn showed arterial hypoxaemia and abnormalities in ventilation-perfusion relationships. Challenge with 200 mg nitrofurantoin produced increased minute ventilation, hypoxaemia, hypocapnia, deterioration in ventilationperfusion relationships, marked veno-arterial shunting, and a fall in steady-state transfer factor for carbon monoxide and fractional carbon monoxide uptake. Spirometry and lung volume measurements indicated a restrictive lung abnormality without effect on large airways which persisted for at least nine weeks. Three years later there had been complete resolution of the process, apart from some persistent reduction in transfer factor, possibly related to the patient's smoking habits.

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Subacute Pulmonary Infiltration Due to Nitrofurantoin

Cited by 38 publications

References 6 publications

Pleuro‐pulmonary Allergic Reaction to Nitrofurantoin

Pleuro‐pulmonary Allergic Reaction to Nitrofurantoin

LUPUS‐LIKE SYNDROME ASSOCIATED WITH PULMONARY REACTION TO NITROFURANTOIN: Report of Three Cases

Acute pulmonary reaction to nitrofurantoin

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