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Korean J Hepatol. 2009;15(2):159-167. Published online June 30, 2009.
DOI: https://doi.org/10.3350/kjhep.2009.15.2.159
- Clinical features of hepatic tuberculosis in biopsy-proven cases
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- Abstract
- Backgrounds/Aims
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. (Korean J Hepatol 2009;15:
159-167)
Keywords :Hepatic tuberculosis; Primary; Miliary; Abscess
