Kalinga Bommankatte Eranaik1, Santosh Vastrad2, Basangouda Sangangouda Patil3

BACKGROUND Infection with mycobacterium tuberculosis is most often found in well-oxygenated areas of the body such as the apices of the lung and renal cortex, it does affect liver in many ways. This kind of infection in the liver is usually secondary from TB of the lung or other organ.
The aim of this study is to assess the liver function test abnormalities and histopathological changes on liver biopsy in tuberculosis and to correlate with biochemical and histopathological changes in tuberculosis patients.
MATERIALS AND METHODS This cross-sectional observational study was carried out on 50 cases of tuberculosis patients admitted in medical wards at KIMS Hospital, Hubli. Out of 50 study participants, 40 were suffering from pulmonary and remaining 10 from disseminated tuberculosis. The need for liver biopsy was clinically assessed by the evaluating hepatologist following a complete physical examination and appropriate radiological imaging. Vitamin K 5 mg/day was given IM for three consecutive days prior to liver biopsy ruling out all contraindications and coagulation or bleeding disorders.
In this study, male-to-female ratio was 3.5:1 with peak incidence among 20-40 years of age. Chest x-ray revealed nonhomogenous fibrocaseous lesions in 86% followed by cavitatory lesions in 52% of cases. Hepatic granuloma was 12% all being seen in disseminated tuberculosis. Nonspecific changes were seen in 88% of cases. Most common being fatty infiltration (64%) and lymphocytic infiltration (68%).
This study concluded that the incident of hepatic granuloma was seen in disseminated tuberculosis. Diagnosis of hepatobiliary tuberculosis should be considered in any patient with hepatomegaly, especially if accompanied by weight loss and in suspicious cases, a liver biopsy should be performed without delay, since this condition responds well to early antituberculous therapy.