Toptas Tayfur, Ilhan Birkan, Bilgin Huseyin, Dincses Elif, Ozdogan Osman, Kaygusuz-Atagunduz Isik, Odabasi Zekaver, Korten Volkan, Firatli-Tuglular Tulin
Department of Hematology, Van Training and Research Hospital, 65300 Van, Turkey.
Department of Internal Medicine, Marmara University Hospital, Istanbul, Turkey.
Case Rep Infect Dis. 2015;2015:759341. doi: 10.1155/2015/759341. Epub 2015 Sep 7.
Hepatobiliary tuberculosis is uncommon even in endemic countries. It is associated with a high mortality and is even diagnosed early in the disease course. Acute liver failure (ALF) caused by tuberculosis bacilli has been reported in only a few reports. All previous cases have been diagnosed by postmortem examination. Time to antituberculosis treatment is very critical. In case of suggestive findings on clinical and radiologic examination, antituberculosis treatment should be initiated immediately. Drug use can be a challenge in patients with ALF. However, as long as the other possible causes of ALF can be excluded and hepatotoxic drugs were avoided during the early course of treatment, such a highly fatal presentation of tuberculosis can be treated safely. Here, we report a case of acute liver failure as a presentation of miliary tuberculosis. He was treated successfully with antituberculosis treatment.
肝胆结核即便在结核病流行国家也不常见。它与高死亡率相关，甚至在疾病早期就被诊断出来。由结核杆菌引起的急性肝衰竭（ALF）仅有少数报道。既往所有病例均通过尸检确诊。开始抗结核治疗的时机非常关键。如果临床和影像学检查有提示性发现，应立即开始抗结核治疗。对于急性肝衰竭患者，药物使用可能是一项挑战。然而，只要能排除急性肝衰竭的其他可能病因，并且在治疗早期避免使用肝毒性药物，这种极具致命性的结核病表现是可以安全治疗的。在此，我们报告一例以粟粒性结核为表现的急性肝衰竭病例。患者通过抗结核治疗成功治愈。
