title: [Clinical features of hepatic tuberculosis in biopsy-proven cases].
abstract: OBJECTIVE
  Hepatic involvement is frequently observed in patients with miliary tuberculosis, but primary hepatic tuberculosis with no clinical extrahepatic manifestations of tuberculosis is uncommon. With the ever-increasing number of immunocompromised patients, it is expected that hepatic tuberculosis will occur more frequently. The aim of the present study was to establish the clinical manifestations and course of the disease.
  
  
  METHODS
  From January 1989 to September 2008, 12 patients were diagnosed with hepatic tuberculosis by liver biopsy at Seoul National University Hospital. We retrospectively evaluated their clinical, laboratory, and imaging findings by medical record review.
  
  
  RESULTS
  Four patients had primary hepatic tuberculosis, and eight patients had hepatic tuberculosis secondary to pulmonary or miliary tuberculosis. Three patients were immunocompromised, and six patients had no previous medical problem. An elevated serum level of alkaline phosphatase was the most frequently observed finding in laboratory tests. Imaging studies showed variable findings, including hepatosplenomegaly, multiple hepatic nodules, abscess formation, and even normal findings. Ten patients responded to antituberculosis drugs, and two cases with tuberculous liver abscess had persistent disease despite prolonged therapy.
  
  
  CONCLUSIONS
  In patients with a protracted illness, hepatosplenomegaly and/or abnormal liver function tests, hepatic tuberculosis should be suspected, even in healthy young patients or patients with normal imaging findings. Patients with tuberculous abscess formation tend to respond poorly to antituberculosis therapy, and surgery could be considered in these patients.
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors: Sung Wook
authors: SW
authors: Hwang
authors: Yoon Jun
authors: YJ
authors: Kim
authors: Eun Ju
authors: EJ
authors: Cho
authors: Jong Kyung
authors: JK
authors: Choi
authors: Se Hyung
authors: SH
authors: Kim
authors: Jung-Hwan
authors: JH
authors: Yoon
authors: Chung Yong
authors: CY
authors: Kim
authors: Hyo-Suk
authors: HS
authors: Lee
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle; D019963:Clinical Chemistry Tests; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014386:Tuberculosis, Hepatic / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology