Hepatic tuberculosis in absence of disseminated abdominal tuberculosis.
Liver involvement in tuberculosis in absence of miliary tuberculosis is rare. This study was performed to analyse the spectrum and response to treatment of hepatic tuberculosis in the absence of miliary abdominal tuberculosis. Retrospective analysis of seven cases of hepatic tuberculosis without miliary abdominal tuberculosis who presented at the single tertiary referral center were analyzed. All patients presented with fever and hepatomegaly. Five of them had pain in upper abdomen and vomiting. HIV serology was positive in one patient. All patients had normocytic normochromic anaemia, raised erythrocyte sedimentation rate (Mean 65). Mild elevation of liver enzymes and low albumin (Mean 2.4 gm%) with reversal of albumin globulin ratio (Mean 0.6) were seen in all. Two had jaundice. Prothrombin time was normal in all and lactate dehydrogenase values were elevated in all (Mean 794 IU/L). On ultrasonography, 2 had multiple hypodense lesion, 1 had coarse echotexture of liver, 1 had hyperechoic pattern and 3 had just hepatomegaly. Complete resolution of liver lesions on treatment with 4-drug anti-tuberculosis drug chemotherapy was seen. In conclusion, liver tuberculosis has protean manifestations with nonspecific alteration of liver function tests and is best diagnosed on liver biopsy. Overall response to therapy is satisfactory.
Divisions of GI Surgery, Gastroenterology, P.D. Hinduja Hospital and Medical Research Center, Mumbai, India.
Chirag S
CS
Desai
Anand G
AG
Josh
Philip
P
Abraham
Devendra C
DC
Desai
Ramesh B
RB
Deshpande
Anita
A
Bhaduri
Sudeep R
SR
Shah
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014374:Tuberculin Test; D014386:Tuberculosis, Hepatic / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D014391:Tuberculosis, Miliary / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D018608:Ultrasonography, Doppler
D000995:Antitubercular Agents