Vietnamese girl becomes the world's second rarest case of liver tuberculosis.

A 20-year-old female student from Dong Thap province, suffering from hepatic tuberculosis on top of Wilson's disease, had to undergo treatment for over 3 years at Cho Ray Hospital.

No longer looking as frail as she did when she first arrived at the hospital, the patient is now a pretty, healthy college student. After relentlessly seeking treatment everywhere since the age of 16, she was diagnosed with Wilson's disease (a copper metabolism disorder) and subsequently embarked on a battle against liver tuberculosis. This is only the second known case in the world.

Dr. Le Huu Phuoc, from the Hepatitis Research and Treatment Department at Cho Ray Hospital, stated that the patient was admitted on May 10, 2013. Prior to this, the patient experienced menstrual irregularities, followed by complete amenorrhea without a clear cause. The young woman also frequently suffered from swelling and pain in her ankle and knee joints, which did not improve with painkillers and anti-inflammatory drugs. She developed additional symptoms of anemia and gradually showed signs of liver damage such as jaundice, yellowing of the eyes, edema of the extremities, and abdominal distension.

The image shows decreased density in segment IV of the liver.

Faced with a patient presenting with many unusual symptoms, the doctors conducted numerous paraclinical tests. Hematological and biochemical test results showed that the copper content in the urine was six times higher than normal.The virus also tested negative for common hepatitis viruses. Along with genetic analysis, ultrasound, CT scans, etc., the patient was diagnosed with Wilson's disease.

After treatment with copper chelation therapy, liver support, blood transfusions, etc., the patient gradually recovered. The symptoms completely disappeared after 12 months. The patient also resumed menstruation after 18 months. However, after 24 months of treatment, when the clinical condition was improving, a routine abdominal ultrasound revealed a liver tumor. A liver biopsy showed the presence of cells suggestive of tuberculosis.

"At the timeDoctors were surprised to discover hepatic tuberculosis in Wilson's disease patient."Because this case is extremely rare," Dr. Phuoc shared.After receiving anti-tuberculosis treatment, the patient is now recovering well and is able to attend school and live a normal life.

The recovering patient chats with the doctor. Photo: Le Phuong.

Dr. Nguyen Thanh Xuan, HeadThe Department of Hepatitis Research and Treatment reported that the first case discovered worldwide was a 16-year-old patient in Morocco. Hepatic tuberculosis is rare because the liver is an oxygen-poor organ, unsuitable for the growth of tuberculosis bacteria. The disease usually occurs in immunocompromised individuals such as HIV patients.If left untreated, it can be fatal.

"It's possible that in these two cases, the Wilson's disease medication, in addition to its copper-chelating effect, also suppressed the immune system, giving hepatic tuberculosis a chance to develop," Dr. Xuan analyzed.

According to VNE