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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...

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Autores principales: Bhatt, Chaitanya, Doleeb, Zainab, Bapat, Priya, Pagnoux, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
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.
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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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