Bronchiolitis obliterans organising pneumonia associated with the use of nitrofurantoin

The spectrum of nitrofurantoin lung injury continues to widen. The case histories are presented of two patients who developed lung disease associated with the use of nitrofurantoin with histological features of bronchiolitis obliterans organising pneumonia (BOOP), a rare but recognised form of drug...

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Bibliographic Details
Published in:Thorax 2000-03, Vol.55 (3), p.249-251
Main Authors: Cameron, R J, Kolbe, J, Wilsher, M L, Lambie, N
Format: Article
Language:English
Subjects:
Adult
Anti-Infective Agents, Urinary - adverse effects
Anti-Inflammatory Agents - therapeutic use
Biological and medical sciences
bronchiolitis obliterans organising pneumonitis
Case Report
Cryptogenic Organizing Pneumonia - chemically induced
Cryptogenic Organizing Pneumonia - diagnosis
Cryptogenic Organizing Pneumonia - drug therapy
drug induced pulmonary disease
Drug toxicity and drugs side effects treatment
Female
Forced Expiratory Volume
Humans
Infections
Lung diseases
Medical sciences
Middle Aged
nitrofurantoin
Nitrofurantoin - adverse effects
Patients
Pharmacology. Drug treatments
Physiology
Prednisone - therapeutic use
Tomography, X-Ray Computed
Toxicity: respiratory system, ent, stomatology
Urinary tract diseases
Urogenital system
Vital Capacity
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Summary:The spectrum of nitrofurantoin lung injury continues to widen. The case histories are presented of two patients who developed lung disease associated with the use of nitrofurantoin with histological features of bronchiolitis obliterans organising pneumonia (BOOP), a rare but recognised form of drug induced injury. The two middle aged women presented with respiratory symptoms after prolonged treatment with nitrofurantoin. Both had impaired lung function and abnormal computed tomographic scans, and their condition improved when nitrofurantoin was withdrawn and corticosteroid treatment commenced. The favourable outcome in these two patients contrasts with the fatal outcome of the two other reported cases of nitrofurantoin induced BOOP. We suggest that the previous classification of nitrofurantoin induced lung injury into “acute” and “chronic” injury is an oversimplification in view of the wide variety of pathological entities that have subsequently emerged.
ISSN:0040-6376
1468-3296
DOI:10.1136/thorax.55.3.249