Article

Fulminant hepatic failure caused by tuberculosis.

Liver Unit, Queen Elizabeth Hospital, Birmingham.
Gut (Impact Factor: 10.73). 06/1995; 36(5):792-4. DOI: 10.1136/gut.36.5.792
Source: PubMed

ABSTRACT A 54 year old Asian woman developed fulminant hepatic failure followed by renal failure. Because of a past history of possible tuberculosis, she was given antituberculous drugs. The chest x ray was normal. A transjugular liver biopsy showed caseating necrosis, granulomas, and acid fast bacilli indicative of miliary tuberculosis. Despite full supportive therapy, her condition deteriorated and she died. Postmortem examination showed widespread miliary tuberculosis; culture confirmed the presence of Mycobacterium tuberculosis. Tuberculosis causes fulminant hepatic failure rarely and only three cases have been described. In this, as with the other cases, hyponatraemia and hepatomegaly were features at presentation. This is the first report of treatment being given before death.

0 Bookmarks
 · 
62 Views
  • Journal of thoracic disease. 02/2013; 5(1):E1-E4.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To present and discuss 28 female cases with abdominopelvic tuberculosis (TB) and abnormal CA125 levels to better distinguish this disease from advanced ovarian cancer (AOC) and pelvic inflammatory disease (PID). Abdominopelvic tuberculosis (APTB) is one of the extrapulmonary tuberculosis (TB) sites, usually misdiagnosed as AOC and PID and then has to undergo surgery. However, the treatment of APTB is totally based on medical therapy other than surgery except biopsy. This article aims to present and discuss 28 female APTB cases with abnormal CA125 levels to better distinguish this disease from AOC and PID so as to find out non-invasive APTB diagnosis methods. 28 APTB patients diagnosed between January 2000 and January 2010 in our gynecologic department of Nanjing Jinling hospital were reviewed retrospectively and compared with AOC and PID. The mean age was 38.24 ± 11 (range 15-64) years. Elevated levels of serum CA125 were determined in all 28 patients (100 %). Other common findings were ascites in 20 (71.43 %, 20/28), pelvic mass in 21(75 %, 21/28), slight fever with night sweat in 13 (46.43 %, 13/28), cough and pleural effusion in nine (32.14 %, 9/28), high fever more than 39 °C combined with abdominal pain and elevated white blood count in five (17.86 %, 5/28), weight loss more than 5 kg at admission in six (21.43 %, 6/28). Diagnoses were made based on biopsy from laparotomy in 14 (50 %) patients, from laparoscopy in nine (32.14 %), from diagnostic curettage because of primary infertility in two (7.14 %), and only from clinical suspicion in three patients. Histopathology revealed that caseating granulomatous lesions were seen in 25 patients, positive anti-acid staining in 11 patients. Totally 26 patients completed anti-TB therapy successfully and were cured, two patients died of the disease because of long-term immune inhibitor used. Although it is difficult to exactly distinguish APTB from AOC and PID without operation, it is important because the treatment of APTB is totally based on medical therapy other than surgery. Some difference may be found out if clinical manifestation, physical examination, laboratory tests and imaging findings are carefully analyzed to avoid unnecessary extensive surgery and improve the prognosis.
    Archives of Gynecology 10/2013; · 0.91 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Hepatobiliary tuberculosis is a rare manifestation of Mycobacterium tuberculosis infection and is usually secondary to tuberculosis of the lungs or gastrointestinal tract. Diagnosis is difficult pre-operatively in local (focal and tubular) forms because of its rarity and presentation in the form of non-specific symptoms and signs and lack of any defined criteria on imaging studies. Histopathological examination is necessary for definite diagnosis but in cases where there is suspicion of hepatobiliary tuberculosis, with PCR assay diagnosis it is possible pre-operatively. Recommended treatment is with conventional antituberculous drugs and surgical intervention in tuberculous abscess or granulomas. The disease is usually associated with good prognosis under complete antituberculous treatment. The author encountered 4 cases of hepatobiliary tuberculosis over 5 years. The aim of this article is to present current knowledge of hepatobiliary tuberculosis and to comprehensively review all the available literature.
    Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology. 01/2014; 27(3):207-211.

Full-text (2 Sources)

View
17 Downloads
Available from
May 15, 2014