Hepatobiliary tuberculosis in western India.
Indian J Pathol Microbiol
;
2008 Apr-Jun; 51(2): 175-81
Article
Dans Anglais
| IMSEAR
| ID: sea-73034
ABSTRACT
Tuberculous involvement of liver as a part of disseminated tuberculosis is seen in up to 50-80% cases, but localized hepatobiliary tuberculosis (HBTB) is uncommonly described. During 6 years, a total of 280 consecutive patients with TB were evaluated prospectively for the presence and etiology of liver involvement. Cases with miliary TB or immunosuppression and cases receiving anti-tuberculosis drugs prior to presentation to our unit were excluded (38 cases). Details of clinical, biochemical and imaging findings and histology/microbiology were noted. Of 242 included cases, 38 patients (15.7%; age 38.1 +/- 12.5 years; sex ratio 2.51) had HBTB, whereas 20 patients (9%; age 39.3 +/- 16.3 years; sex ratio 2.11) had other liver diseases. Diagnosis of HBTB was based on caseating granuloma on histology (18/23 procedures), positive smear/culture for acid-fast bacilli (21/39 procedures) and positive polymerase chain reaction for Mycobacterium tuberculosis (28/29 procedures) when diagnostic procedures were guided by imaging results. Thirty-eight cases with HBTB were classified as follows [patients (n), (%)] (A) hepatic TB [20 (52.6%)] (1) granulomatous hepatitis - 10 (26.3%), (2) liver abscesses or pseudotumors - 10 (26.3%) and (3) calcified hepatic granuloma - 0 (0%); (B) biliary TB [15 (39.4%)] (1) biliary strictures - 2 (5.2%), (2) gall bladder involvement - 1 (2.6%) and (3) biliary obstruction due to lymph node masses - 12 (31.5%); (C) mixed variety [3 (7.8%)] (1) simultaneous granulomatous hepatitis and biliary stricture - 1 (2.6%) and (2) simultaneous lymph node involvement and calcified hepatic granuloma - 2 (5.2%). All the cases responded well to standard anti-tuberculosis therapy. HBTB forms an important subgroup in TB cases. It requires a combination of imaging, histological and microbiological procedures to define the diagnosis. HBTB responds well to treatment.
Texte intégral:
Disponible
Indice:
IMSEAR (Asie du Sud-Est)
Sujet Principal:
Tuberculose hépatique
/
Maladie des voies biliaires
/
Femelle
/
Humains
/
Mâle
/
ADN bactérien
/
Séquence nucléotidique
/
Études prospectives
/
Amorces ADN
/
Adulte
Type d'étude:
Étude observationnelle
Pays comme sujet:
Asie
langue:
Anglais
Texte intégral:
Indian J Pathol Microbiol
Année:
2008
Type:
Article
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