ABSTRACT
Localized hepatic tuberculosis (TB) with or without bile duct involvement is a rare form of hepatobiliary tuberculosis; accounting for less than 1% of all tuberculous infections. We report an uncommon case of cholestatic jaundice with disseminated TB in an immunocompetent male who presented with simultaneous involvement of liver and biliary system.
Subject(s)
Common Bile Duct Diseases/diagnosis , Tuberculosis, Hepatic/diagnosis , Antitubercular Agents/therapeutic use , Biopsy, Fine-Needle , Cholestasis/etiology , Common Bile Duct Diseases/complications , Common Bile Duct Diseases/diagnostic imaging , Common Bile Duct Diseases/drug therapy , Constriction, Pathologic/complications , Constriction, Pathologic/diagnosis , Diagnosis, Differential , Humans , Jaundice/etiology , Male , Tuberculosis, Hepatic/complications , Tuberculosis, Hepatic/drug therapy , Tuberculosis, Hepatic/pathology , Young AdultABSTRACT
BACKGROUND: Inflammatory bowel disease (IBD) has been associated with increased risk of osteopenia and osteoporosis. Several risk factors contribute to this; however, studies evaluating their association have conflicting results. METHODS: We conducted a cross-sectional study with prospective enrollment of adult ulcerative colitis patients attending the Gastroenterology Department of Sawai Man Singh Hospital, Jaipur Rajasthan between June 2015 and December 2015. Demographic data including age, gender, body mass index (BMI), disease duration, type of disease, prior steroid use and vitamin D levels were recorded and compared with bone mineral density (BMD) using dual-energy X-ray absorptiometry (DEXA). RESULTS: Of the 55 patients enrolled, 41 (74.5%) had abnormal BMD; out of this, 19 (34.5%) had osteopenia and 22 (40.0%) had osteoporosis. In univariate analysis, disease duration and history of steroid use were observed as statistically significant. However, on multivariate analysis, only duration of disease was found to be a significant independent predictor of low BMD. Age, gender, BMI, low levels of vitamin D and steroid usage were not associated with low BMD. CONCLUSION: Prevalence of low BMD is common in Indian ulcerative colitis patients. Prolonged disease duration appears to be the major risk factor.
