Rare adverse effect of a common drug: nitrofurantoin-induced ANCA-associated vasculitis

BMJ Case Rep. 2015 May 2:2015:bcr2014209253. doi: 10.1136/bcr-2014-209253.

Abstract

Nitrofurantoin is commonly prescribed to treat urinary tract infections (UTI). Reported adverse effects include gastrointestinal, pulmonary, hepatic and neurological disorders. We report a case of a 67-year-old woman treated for UTI with nitrofurantoin who presented with antineutrophilic cytoplasmic antibody (ANCA)-associated renal and skin vasculitis 3 days after starting treatment. The symptoms resolved following withdrawal of the drug and treatment with steroids. This is the first reported case of nitrofurantoin causing ANCA-associated vasculitis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Infective Agents, Urinary / administration & dosage
  • Anti-Infective Agents, Urinary / adverse effects*
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / chemically induced
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / diagnosis*
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / drug therapy
  • Antibodies, Antineutrophil Cytoplasmic / metabolism*
  • Female
  • Fever / chemically induced*
  • Fever / drug therapy
  • Fever / immunology
  • Humans
  • Nitrofurantoin / administration & dosage
  • Nitrofurantoin / adverse effects*
  • Purpura / chemically induced*
  • Purpura / drug therapy
  • Purpura / immunology
  • Treatment Outcome
  • Urinary Tract Infections / drug therapy*

Substances

  • Anti-Infective Agents, Urinary
  • Antibodies, Antineutrophil Cytoplasmic
  • Nitrofurantoin