급성 간염으로 내원하여 진단된 파종결핵 1예
A case of tuberculosis hepatitis diagnosed in a patient presenting with acute hepatitis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
파종결핵에서 급성 간염은 그 빈도가 매우 드물고 간조직생검을 필요로 하기 때문에 초기에 간과되기 쉽다. 저자들은 급성간염으로 내원한 환자에서 파종결핵을 진단하고 결핵치료를 통해 간염을 치료한 1예를 경험하였기에 보고한다.
Abstract
Involvement of the liver is very common in military tuberculosis, but despite this fact, jaundice and hepatocellular dysfunction very rarely occur in this disease. Here, we report the case of a 59-year-old male patient who presented with acute hepatitis. After being admitted for fever and right upper quadrant pain for a 3-day period, military tuberculosis was diagnosed and treated with antituberculosis medication. Despite treatment, which was based on laboratory results and radiologic findings suggestive of acute hepatitis, fever persisted, jaundice developed, and hepatic enzyme levels increased. Percutaneous liver biopsy was performed to assist in the differential diagnosis of acute hepatitis and findings from the biopsy specimen revealed typical hepatic tuberculosis. Antituberculosis treatment was initiated, and the fever gradually subsided and hepatic enzyme levels decreased.
참고문헌 (13)
- Friedman LS, "Laboratory evaluation of the patient with liver disease. In Hepatology: a textbook of liver disease. 4th ed", pp.690~692 (2003), Saunders
- Hussain W, "Fulminant hepatic failure caused by tuberculosis", Gut, 36, pp.792~794 (1995)
- Cruice JM, "Jaundice in tuberculosis", Am J Med Sci, 147, pp.720~726 (1914)
- Evans RH, "Massive hepatosplenomegaly, jaundice and pancytopenia in military tuberculosis", J Infect, 36, pp.236~239 (1998)
- Essop AR, "Tuberculosis hepatitis: a clinical review of 96 cases", Q J Med, 53, pp.465~477 (1984)
- Reported tuberculosis in the United States, , U.S. Department of Health and Human Services, CDC, ~ (2002)
- Schiff L, "Hepatitis associated with systemic infections. In Disease of the liver", pp.711~ (1975), J. B. Lippincott
- Godwin JE, "Miliary tuberculosis presenting as hepatic and renal failure", Chest, 99, pp.752~754 (1991)
- Sanchez-Tapias JM, "Tuberculosis of the liver. In Oxford textbook of clinical hepatology. Vol. 1", pp.688~689 (1991), Oxford University Press
- Curry FJ, "Tuberculous hepatitis with jaundice: report of two cases", Gastroenterology, 28, pp.1037~1042 (1955)
- Sharma SK, "Disseminated tuberculosis presentating as massive hepatosplenomegaly and hepatic failure", Am J Gastroenterol, 76, pp.153~156 (1981)
- Wilfredo T, "Extrapulmonary tuberculosis. In Tuberculosis, current concepts and treatment. 2nd ed", pp.139~190 (2001), CRC press
- Kang GH, "Confirmation of tuberculosis hepatitis using polymerase chain reaction", Korean J Gastroenterol, 30, pp.415~419 (1997)