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Drug-induced haemolysis: another reason to be cautious with nitrofurantoin
We report the case of a previously healthy woman in her 60s who presented to the emergency department with acute confusion, vomiting and fever. She was recently diagnosed with a urinary tract infection as an outpatient and had completed the fifth day of a 7-day course of treatment with nitrofurantoi...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9815031/ https://www.ncbi.nlm.nih.gov/pubmed/36596629 http://dx.doi.org/10.1136/bcr-2022-251119 |
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author | Bhatt, Chaitanya Doleeb, Zainab Bapat, Priya Pagnoux, Christian |
author_facet | Bhatt, Chaitanya Doleeb, Zainab Bapat, Priya Pagnoux, Christian |
author_sort | Bhatt, Chaitanya |
collection | PubMed |
description | We report the case of a previously healthy woman in her 60s who presented to the emergency department with acute confusion, vomiting and fever. She was recently diagnosed with a urinary tract infection as an outpatient and had completed the fifth day of a 7-day course of treatment with nitrofurantoin. We maintained a wide differential diagnosis including infectious, metabolic, autoimmune and medication-related causes. She developed an acute normocytic anaemia in hospital with a haemoglobin drop from 121 g/L to 89 g/L. Further investigation revealed evidence of haemolysis with an elevated bilirubin, lactate dehydrogenase, reticulocyte count and decreased haptoglobin. She was worked up for both inherited and acquired causes of haemolysis and found to have glucose-6-phosphate dehydrogenase deficiency. Her presentation was thought to be secondary to nitrofurantoin-induced haemolysis and she recovered completely with conservative management through intravenous fluids and discontinuation of nitrofurantoin. |
format | Online Article Text |
id | pubmed-9815031 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-98150312023-01-06 Drug-induced haemolysis: another reason to be cautious with nitrofurantoin Bhatt, Chaitanya Doleeb, Zainab Bapat, Priya Pagnoux, Christian BMJ Case Rep Case Reports: Adverse drug reactions and complications We report the case of a previously healthy woman in her 60s who presented to the emergency department with acute confusion, vomiting and fever. She was recently diagnosed with a urinary tract infection as an outpatient and had completed the fifth day of a 7-day course of treatment with nitrofurantoin. We maintained a wide differential diagnosis including infectious, metabolic, autoimmune and medication-related causes. She developed an acute normocytic anaemia in hospital with a haemoglobin drop from 121 g/L to 89 g/L. Further investigation revealed evidence of haemolysis with an elevated bilirubin, lactate dehydrogenase, reticulocyte count and decreased haptoglobin. She was worked up for both inherited and acquired causes of haemolysis and found to have glucose-6-phosphate dehydrogenase deficiency. Her presentation was thought to be secondary to nitrofurantoin-induced haemolysis and she recovered completely with conservative management through intravenous fluids and discontinuation of nitrofurantoin. BMJ Publishing Group 2023-01-03 /pmc/articles/PMC9815031/ /pubmed/36596629 http://dx.doi.org/10.1136/bcr-2022-251119 Text en © BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ. |
spellingShingle | Case Reports: Adverse drug reactions and complications Bhatt, Chaitanya Doleeb, Zainab Bapat, Priya Pagnoux, Christian Drug-induced haemolysis: another reason to be cautious with nitrofurantoin |
title | Drug-induced haemolysis: another reason to be cautious with nitrofurantoin |
title_full | Drug-induced haemolysis: another reason to be cautious with nitrofurantoin |
title_fullStr | Drug-induced haemolysis: another reason to be cautious with nitrofurantoin |
title_full_unstemmed | Drug-induced haemolysis: another reason to be cautious with nitrofurantoin |
title_short | Drug-induced haemolysis: another reason to be cautious with nitrofurantoin |
title_sort | drug-induced haemolysis: another reason to be cautious with nitrofurantoin |
topic | Case Reports: Adverse drug reactions and complications |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9815031/ https://www.ncbi.nlm.nih.gov/pubmed/36596629 http://dx.doi.org/10.1136/bcr-2022-251119 |
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