Features and Outcome of Hepatobiliary Tuberculosis among Filipino Children: Report of a Six-year Experience
- Author:
Evangeline P. Capul
1
;
Germana Emerita V. Gregorio
1
;
Ma. Liza Antoinette M. Gonzales
1
;
Author Information
- Publication Type:Journal Article
- Keywords: hepatobiliary TB; hepatic granuloma; hepatic calcification; AFB smear; TB PCR
- MeSH: Polymerase Chain Reaction; Granuloma
- From: Acta Medica Philippina 2020;54(5):551-557
- CountryPhilippines
- Language:English
-
Abstract:
Background:The features and outcome of hepatobiliary tuberculosis (HBTB) have not been extensively reported in children.
Objective:To describe the clinical, biochemical, radiologic, microbiologic and histologic features and outcome of children diagnosed with HBTB.
Methods:Data of HBTB patients aged 0-18 years were collected by review of medical records and as they were admitted. Cases were classified as bacteriologically-confirmed (positive AFB smear, TB culture or PCR of bile/liver tissue) or clinically-diagnosed (clinical, histologic and/or radiologic evidence).
Results:A total of 36 patients were included (mean age: 13yrs; 64% males): three bacteriologically-confirmed and 33 clinically-diagnosed. Most common signs/symptoms were weight loss (69%), fever (67%), hepatomegaly (61%) and jaundice (53%). Of the total, 68% had hypoalbuminemia, 50% increased transaminases and 47% prolonged prothrombin time. Fifteen (42%) patients were AFB positive on various microbiologic specimens. Most common imaging finding was hepatic calcification (64%). Of 11 patients with liver biopsy, seven (64%) had chronic/ granulomatous inflammation. All 36 were managed medically. Eight were lost to follow up, six died, and 22 (61%) are alive, nine with complete resolution of liver disease.
Conclusion:Hepatobiliary tuberculosis presents with non-specific clinical and biochemical findings. Several investigations are necessary to confirm the diagnosis. Overall response to anti-TB treatment is satisfactory with possible resolution of liver disease. - Full text:2251-Article Text-11725-1-10-20201028.pdf
