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Hepatic involvement in tuberculosis

S Gupta1, H S Meena, R Chopra

  • 1Department of Medicine, Lady Harding Medical College, New Delhi.

The Journal of the Association of Physicians of India
|January 1, 1993
PubMed
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Tuberculosis can affect the liver, causing changes seen in biopsies. Early liver inflammation and nodules may precede granuloma formation in tuberculosis diagnosis.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Pathology

Background:

  • Tuberculosis (TB) is a significant global health challenge.
  • Liver involvement in TB can present with varied histopathological findings.
  • Distinguishing TB from other causes of fever of unknown origin (FUO) can be difficult.

Purpose of the Study:

  • To investigate the spectrum of liver histopathology in confirmed tuberculosis cases.
  • To evaluate liver function tests (LFTs) and liver biopsy findings in tuberculosis and FUO suspected to be tubercular.
  • To identify early pathological changes in the liver that may indicate tuberculosis.

Main Methods:

  • Inclusion of 71 confirmed tuberculosis cases (pulmonary and extrapulmonary) and 13 FUO cases suspected of TB.
  • Comprehensive clinical evaluation, including LFTs and liver biopsy for all participants.

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  • Histopathological analysis of liver biopsies for specific TB-related changes.

    • Main Results:

    • Only 7% of tuberculosis cases showed LFT alterations, compared to 23% in the FUO group.
    • Histopathological changes were observed in 63% of tuberculosis cases and 46.16% of FUO cases.
    • Common findings in TB liver biopsies included caseating granulomas (18.30%), non-specific inflammatory infiltration (25.32%), Kupffer cell hyperplasia (11.2%), and fatty changes (8.45%).

    Conclusions:

    • While caseating granulomas are characteristic of hepatic tuberculosis, non-specific inflammatory hepatitis and reticulonodular changes may be earlier indicators.
    • These non-specific findings in FUO cases that responded to anti-TB therapy suggest their role as precursors to granuloma formation.
    • Liver biopsy is a valuable tool in diagnosing hepatic tuberculosis, especially in cases with subtle LFT abnormalities.