[Change in liver size caused by antitubercular combination therapy]

Area of Science:

• Hepatology
• Pharmacology
• Medical Imaging

Background:

• Antituberculous therapies are crucial for managing tuberculosis.
• Hepatotoxicity is a potential concern with some antitubercular drugs.
• Monitoring liver size during treatment can provide insights into drug effects.

Purpose of the Study:

• To investigate ultrasonographically the changes in liver dimensions during antituberculous combination treatment.
• To identify factors influencing liver size changes in patients receiving antitubercular therapy.

Main Methods:

• Ultrasonographic measurements of liver lobe dimensions were performed every two weeks in 23 patients.
• Data analysis correlated liver size changes with patient age, sex, alcohol history, adverse reactions, and acetylator status.

Main Results:

• Significant liver lobe enlargement (average 11%) was observed starting from the 4th-6th week of treatment.
• Older patients (>40 years) and those with a history of alcohol abuse showed more pronounced liver size increases.
• No significant differences in the time course of liver size changes were noted related to sex or adverse reactions.
• Slow acetylators exhibited a slightly greater increase in liver size compared to rapid acetylators.
• No clinically relevant hepatotoxic side effects or strict correlation between transaminase elevations and liver architecture changes were found.

Conclusions:

• Antituberculous treatment can lead to ultrasonographically detectable liver enlargement.
• Patient age and history of alcohol abuse are associated with greater increases in liver size.
• Despite observed liver size changes, clinically relevant hepatotoxicity was not identified in this study cohort.