Hepatic involvement in extrapulmonary tuberculosis

Korn, R; Kellow, William F.; Heller, Paul; Chomet, Bernhard; Zimmerman, Hyman J.

doi:10.1016/0002-9343(59)90061-0

Cited by 68 publications

(10 citation statements)

References 31 publications

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“…5–8 The role these abnormalities might play in the development of symptoms and signs of ADIH during chemotherapy must remain speculative. Similar studies in children have been reported.…”

Section: Resultsmentioning

confidence: 99%

Antituberculosis Drug-Induced Hepatotoxicity in Children

Donald

2011

Pediatric Reports

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Recent increases in the dosages of the essential antituberculosis agents isoniazid (INH), rifampicin (RMP), pyrazinamide (PZA) for use in children recommended by World Health Organization have raised concerns regarding the risk of hepatotoxicity. Published data relating to the incidence and pathogenesis of antituberculosis drug-induced hepatotoxicity (ADIH), particularly in children, is reviewed. Amongst 12,708 children receiving chemoprophylaxis, mainly with INH, but also other combinations of INH, RMP and PZA only 1 case (0.06%) of jaundice was recorded and abnormal liver functions documented in 110 (8%) of the 1225 children studied. Excluding tuberculous meningitis (TBM) 8984 were children treated for tuberculosis disease and jaundice documented in 75 (0.83%) and abnormal liver function tests in 380 (9.9%) of the 3855 children evaluated. Amongst 717 children treated for TBM, however, jaundice occurred in 72 (10.8%) and abnormal LFT were recorded in 174 (52.9%) of those studied. Case reports document the occurrence of ADIH in at least 63 children. Signs and symptoms of ADIH were frequently ignored in the recorded cases. ADIH can occur in children at any age or at any dosage of INH, RMP or PZA, but the incidence of.ADIH is is considerably lower in children than in adults. Children with disseminated forms of disease are at greater risk of ADIH. The use of the higher dosages of INH, RMP and PZA recently recommended by WHO is unlikely to result in a greater risk of ADIH in children.

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“…5–8 The role these abnormalities might play in the development of symptoms and signs of ADIH during chemotherapy must remain speculative. Similar studies in children have been reported.…”

Section: Resultsmentioning

confidence: 99%

Antituberculosis Drug-Induced Hepatotoxicity in Children

Donald

2011

Pediatric Reports

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“…Most lesions of hepatic tuberculosis are small. 31 Giant nodular lesions greater than 3 cm in diameter are distinctly rare. 26 32-34 So called macronodular tuberculoma was first described by Bristowe et al in 1858.…”

Section: Discussionmentioning

confidence: 99%

The nodular form of hepatic tuberculosis: a review with five additional new cases

Huang

Cc²,

Wj³

et al. 2003

Journal of Clinical Pathology

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“…Realistically, caseation necrosis in these diseases is rare but we see these diseases in our patient population so this differential diagnosis must be kept in mind when evaluating hepatic granulomata. [10][11][12] In this case, special stains demonstrated acid-fast bacilli. Evaluation of liver biopsies in patients ultimately proven to have tuberculosis has yielded some relatively consistent findings.…”

Section: Theodore M Bailey Iii Mdmentioning

confidence: 70%

“…However, special stains for acid-fast bacilli will demonstrate the organisms in only about ten percent of cases. [9][10][11][12] In conclusion, this liver biopsy shows miliary involvement by tuberculous granulomata. This case also demonstrates that the liver biopsy is a valuable tool in cases of suspected tuberculosis not yet proven by other methods.…”

Section: Theodore M Bailey Iii Mdmentioning

confidence: 76%

Clinicopathologic Conference

Froude¹,

Lewall

Bailey

1982

Ann Saudi Med

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A 42-year-old married Saudi Arabian woman with three children was referred to the King Faisal Specialist Hospital and Research Centre because of fever with malaise and breathlessness of six weeks' duration.She had been treated at another hospital for one month where her symptoms gradually worsened until she was breathless on minimal exertion. There was neither orthopnea nor paroxysmal nocturnal dyspnea. She had a dry cough, occasionally producing small amounts of white sputum.Over the two weeks prior to admission, she had had intermittent episodes of stabbing, left-sided chest pain that was sometimes aggravated by deep breathing.At the other hospital, she had received courses of cefazolin sodium, ampicillin, and trimethoprim and sulfamethoxazole (Septra ® ). No other clinical information was available although she was not thought to have been on steroids or anti-tuberculous drugs. She was not taking the contraceptive pill.The patient had no significant medical history nor was there illness in her family or personal contacts. She thought that she had lost some weight but was not sure. Her bowel habits, micturition, and menses were normal. She was not aware of any allergies.On examination, the patient was yanosed and breathless. Her respiratory rate was 32/min at rest. She had a fever of 39.6°C. Height was 152 cm, weight 53 kg, and blood pressure 120/70 mmHg both lying and sitting. Her pulse was 110/min in sinus rhythm and neck veins were flat. The apical impulse was unremarkable. There was no parasternal heave. The pulmonary second sound was accentuated. There were no murmurs.The patient's trachea was central and chest movement was symmetrical and full. A few crackles that were not cleared by coughing were heard at the left base of the lung. There was neither a pleural nor a pericardial rub.Mouth and fauces were normal. The abdomen was soft and neither her liver nor her spleen could be felt. Her discs and retinae were normal. There were no neurological signs. There was no lymphadenopathy. The thyroid felt normal. Breast and vaginal examinations were normal. There was neither edema nor calf tenderness on examination of the legs.Initial investigations showed hemoglobin 12.2 g/dl; white cell count 8300/cmm; 35% lymphocytes; 52% polymorphonuclear leukocytes; 8% monocytes; 4% eosinophils; and platelets 210,000/cmm. The erythrocyte sedimentation rate was 60 mm in the first hour. Urinalysis showed a trace of protein with no sugar, no bilirubin, and no cells. Chest radiograph showed miliary mottling. A tuberculin skin test (5 units [TU]) showed 10 mm induration.Arterial blood gases, breathing room air with the patient sitting at rest were PO 2 44 mmHg; PCO 2 30 mmHg; pH 7.44; and HCO 3 20meq/1-

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Hepatic involvement in extrapulmonary tuberculosis

Cited by 68 publications

References 31 publications

Antituberculosis Drug-Induced Hepatotoxicity in Children

Antituberculosis Drug-Induced Hepatotoxicity in Children

The nodular form of hepatic tuberculosis: a review with five additional new cases

Clinicopathologic Conference

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