Open AccessLooking beyond appearances: when liver biopsy is the key for hepatic tuberculosis diagnosis
Author(s) -
Marta Freitas,
Joana Magalhães,
Carla Marinho,
José Cotter
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-234491
Subject(s) - medicine , hepatosplenomegaly , differential diagnosis , liver biopsy , asymptomatic , tuberculosis , steatohepatitis , steatosis , radiology , pathology , biopsy , fatty liver , disease
Primary hepatic tuberculosis is a rare clinical entity with non-specific clinical and imaging features that can mimic other liver diseases, representing a diagnostic challenge. We report a case of a 35-year-old man with metabolic syndrome, type 2 diabetes and high alcohol consumption presenting asymptomatic with abnormal liver tests, hepatosplenomegaly and diffuse hepatic steatosis in ultrasound imaging initially suspected to be alcoholic steatohepatitis but later diagnosed as hepatic tuberculosis in the histological specimen. Anti-tuberculosis therapy was started. This clinical case highlights the diagnostic difficulty of hepatic tuberculosis and the importance of not overlooking liver biopsy and to consider it in the differential diagnosis in patients with obvious hepatic injury factors but with atypical clinical presentation.