Vietnamese girl becomes the second rare case of liver tuberculosis in the world

Having liver tuberculosis due to Wilson's disease, a 20-year-old female student in Dong Thap had to be treated for more than 3 years at Cho Ray Hospital.

No longer looking as haggard as when she first came to the hospital, the patient is now a pretty, healthy college student. After being treated everywhere since the age of 16, the girl was diagnosed with Wilson's disease (a copper metabolism disorder) and then entered the fight against liver tuberculosis. This is the second known case in the world.

Doctor Le Huu Phuoc, Department of Hepatitis Research and Treatment, Cho Ray Hospital, said the patient was admitted to the hospital on May 10, 2013. Before that, the patient had menstrual disorders, then complete amenorrhea without finding the cause. The girl also often had painful swelling in her ankles and knees, which did not improve when treated with pain relievers and anti-inflammatory drugs. The patient also had many more symptoms of anemia and gradually showed signs of liver damage such as jaundice, yellow eyes, swollen limbs, abdominal distension...

Image of decreased density in segment IV of the liver.

Faced with a patient with many strange symptoms, doctors conducted many paraclinical tests. The results of hematological and biochemical tests showed that the copper content in urine was 6 times higher than normal. TestsThe virus also tested negative for common hepatitis viruses. Along with genetic analysis, ultrasound, CT... the patient was diagnosed with Wilson's disease.

After treatment with copper chelation, liver support, blood transfusion... the patient gradually recovered. The symptoms of the disease gradually disappeared completely after 12 months. The patient also had her period again after 18 months. However, after 24 months of treatment, when the clinical progress was good, the patient had a periodic abdominal ultrasound and discovered a liver tumor. A liver biopsy showed the presence of cells suggestive of tuberculosis.

"At the timeDetecting liver tuberculosis in Wilson's disease, doctors were very surprisedbecause this case is extremely rare," Dr. Phuoc shared.After receiving anti-tuberculosis treatment, the patient is now recovering well and maintaining normal school attendance and daily activities.

Recovering patient talks with doctor. Photo: Le Phuong.

Doctor Nguyen Thanh Xuan, HeadThe Hepatitis Research and Treatment Department said the first case discovered in the world was a 16-year-old patient in Morocco. Liver tuberculosis is rare because the liver is an organ with poor oxygen, not suitable for the development of tuberculosis bacteria. The disease often occurs in immunocompromised bodies such as HIV patients.If not treated promptly will cause death.

"It is possible that the Wilson's drug in these two cases, in addition to its copper excretion effect, also suppresses the immune system, giving liver tuberculosis a chance to develop," Dr. Xuan analyzed.

According to VNE