Hepatobiliary tuberculosis in western India.

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dc.contributor.authorAmarapurkar, Deepak Nen_US
dc.contributor.authorPatel, Nikhil Den_US
dc.contributor.authorAmarapurkar, Anjali Den_US
dc.date.accessioned2008-04-08en_US
dc.date.accessioned2009-05-29T10:59:38Z
dc.date.available2008-04-08en_US
dc.date.available2009-05-29T10:59:38Z
dc.date.issued2008-04-08en_US
dc.description.abstractTuberculous 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 2.5:1) had HBTB, whereas 20 patients (9%; age 39.3 +/- 16.3 years; sex ratio 2.1:1) 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.en_US
dc.description.affiliationDepartment of Gastroenterology, Bombay Hospital and Medical Research Centre, India.en_US
dc.identifier.citationAmarapurkar DN, Patel ND, Amarapurkar AD. Hepatobiliary tuberculosis in western India. Indian Journal of Pathology & Microbiology. 2008 Apr-Jun; 51(2): 175-81en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/73034
dc.language.isoengen_US
dc.source.urihttps://www.ijpmonline.orgen_US
dc.subject.meshAdulten_US
dc.subject.meshBase Sequenceen_US
dc.subject.meshBiliary Tract Diseases --diagnosisen_US
dc.subject.meshDNA Primers --geneticsen_US
dc.subject.meshDNA, Bacterial --geneticsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshIndiaen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMycobacterium tuberculosis --geneticsen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshTuberculosis, Hepatic --diagnosisen_US
dc.titleHepatobiliary tuberculosis in western India.en_US
dc.typeJournal Articleen_US
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