Vietnamese girl became the second rarest case of tuberculosis in the world

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

There was no longer a shabby look like the hospital day, the patient was now a pretty, healthy student. Roughly running around from the age of 16, the girl discovered Wilson's disease (copper metabolic disorder) and then entered the fight against tuberculosis. This is the second known case in the world .

Dr. Le Huu Phuoc, Department of Hepatitis Research and Treatment for Cho Ray Hospital said that the patient was hospitalized on May 10, 2013. Previously, patients suffered from menstrual disorders, then completely menstrual without finding the cause. The girl also frequently swollen joint pain in the ankles, knees, and did not improve when treated with analgesic, anti-inflammatory drugs. The patient appears more symptoms of anemia and gradually signs of liver damage such as jaundice, yellow eyes, edema, abdominal distention .

Decreased image of attenuated IV segmentation in the liver.

Standing in front of the case with many strange signs, doctors conducted many laboratory tests. Hematological and biochemical test results showed that the copper content in urine increased 6 times compared to normal. Virus tests also give negative results for viruses that cause common hepatitis. Along with genetic analysis, ultrasound, CT . patients are diagnosed with Wilson's disease .

After treating copper waste, liver support, blood transfusion . the patient gradually recovered. The symptoms gradually disappear after 12 months. The patient also had menstrual periods after 18 months. However, after 24 months of treatment, when the clinical process went well, the abdominal ultrasound examination patients periodically detected liver tumors. Liver biopsy shows the presence of a cell type that suggests TB .

"When the liver tuberculosis was detected in Wilson's disease, the doctors were very surprised because this case was extremely rare," Dr. Phuoc said. After receiving anti-tuberculosis treatment, the patient now regains good health and maintains school and normal activities.

Recovering patients talk to the doctor.(Photo: Le Phuong).

Dr. Nguyen Thanh Xuan, Head of Hepatitis Research and Treatment Department, said the first case discovered in the world was a 16-year-old patient in Morocco.Hepatic TB is rare because the liver is an oxygen-poor organ , not suitable for developing TB germs. The disease usually occurs on immunocompromised patients like HIV patients. If not treated promptly, it will cause death.

"There is a possibility that Wilson's medication in these two cases, in addition to the effects of copper excretion, also causes immunosuppression, causing liver tuberculosis to develop," said Dr. Xuan.