antituberculous therapy in patient with cirrhosis

Clinicians and practitioners caring for patients with chronic liver disease are often unsure whether drug therapy is a hazard that increases their patient's risk for drug-induced liver injury (DILI). Areas covered: We searched for reports of drug induced liver injury, both idiosyncratic and intrinsic, in patients with chronic liver disease including non-alcoholic and alcoholic liver disease, and cirrhosis. Reports we analyzed include statin treatment in patients with fatty liver, acetaminophen use in alcoholic fatty liver, antituberculous drugs in patients with tuberculosis and viral hepatitis, antiviral medications in hepatitis and antiretroviral medications in HIV/AIDS...

INTRODUCTION: There is paucity of data on tuberculosis and antituberculous therapy (ATT) induced hepatotoxicity in patients with chronic liver disease. AIM: To study demographic, clinical characteristics of tuberculosis, pattern of drug induced liver injury and treatment responses to ATT in patients with liver cirrhosis. MATERIAL AND METHOD: All cases of liver cirrhosis diagnosed with tuberculosis (TB) between January 2010 and June 2013 were enrolled...

BACKGROUND: Abdominal tuberculosis remains a serious health threat. This retrospective report aimed to analyze patients after the development of the tuberculosis control program by the Center of Disease Control (Taiwan) in January 2000. The study was conducted at the Chang Gung Memorial Hospital-Kaohsiung, Taiwan. METHODS: Between January 2000 and December 2006, we evaluated 14 adult patients with abdominal tuberculosis by reviewing their clinical information, therapeutic methods and outcomes...

OBJECTIVE: To assess the effect of the anterior surgical approach for thoracolumbar spine tuberculosis and analyzed the causes of the surgical complications and the countermeasures. METHODS: From Jan 1996 to Dec 2005, 120 patients with thoracolumbar spine tuberculosis underwent operations through the anterior approach either following the primary diagnosis (115 cases) or for recurrence (5 cases). RESULTS: Intraoperative pleural rupture occurred in 4 cases, and rupture of the external iliac vein occurred 1 case...

A tuberculous liver abscess is an extremely rare condition. However, extrapulmonary tuberculosis is more common in end-stage renal disease patients. We report a 64-year-old woman on hemodialysis with liver cirrhosis. She had no evidence of pulmonary or intestinal tuberculosis on the chest radiograph, abdominal computed tomography (CT), or colonoscopy. She had fever and an enlarged right supraclavicular lymph node. A CT showed several cystic ring-enhancing nodules in the liver. Histopathologic examinations were performed on the enlarged lymph node and a cystic nodule in the liver, which revealed caseating granulomas...

BACKGROUND: Tuberculosis (TB) infection in a liver transplantation candidate is not rare in China. There is little experience on how to manage the pre-existing TB infection in liver transplantation recipients. Aim. Patients with pre-existing pulmonary TB who received liver transplantation are described and the perioperative treatment is discussed. METHODS: The treatment of 3 patients with pre-existing pulmonary TB infection who received liver transplantation was reviewed...

We report a case of systemic phaeohyphomycosis in a 13-year old girl. The clinical presentation was with fever, weight loss, cholestatic jaundice with hepatosplenomegaly and generalized lymphadenopathy. The patient was diagnosed initially as tuberculous adenitis and was on antituberculous therapy, but with worsening of symptoms. Lymph node and liver biopsy showed granuloma with fungal hyphae suggestive of phaeohyphomycosis. The patient responded to antifungal therapy. Later she developed secondary biliary cirrhosis with cholangitis due to long stricture of the common bile duct and common hepatic duct requiring biliary stenting...

Liver disease may produce significant, albeit highly variable, effects on the pharmacokinetic behaviour of antibiotics in serum. Drug disposition may be altered through several pathophysiological mechanisms including reduced hepatobiliary clearance, and modifications in the volume of distribution induced by albumin synthesis deficiency or portal hypertension-related ascites. Antibacterial agents are not affected by potential alteration in hepatic first-pass effects. Only liver cirrhosis-induced effects on serum pharmacokinetics of antibiotics have been extensively studied, unlike those possibly produced by other forms of liver disease...