LAUSR

antigens are presented by major histocompatibility complex class II, activating helper T cells that subsequently recruit cytotoxic T cells, B cells, and natural killer cells, and hepatocytes finally undergo apoptosis. Neoantigens also prompt development of autoantibodies to cytochrome P450. Oxidative stress and mitochondrial dysfunction also play an important role.6 This case demonstrates the importance of recognizing autoimmune-like hepatotoxicity associated with nitrofurantoin because it can lead to cirrhosis. Clinicians should always outweigh the benefits versus risks when prescribing nitrofurantoin and monitor liver function tests periodically when prescribed long -term.