Acute biliary events during anti-tuberculosis treatment: Hospital case series and a nationwide cohort study
Journal
BMC Infectious Diseases
Journal Volume
18
Journal Issue
1
Pages
64
Date Issued
2018
Author(s)
Abstract
Background: Tuberculosis (TB) remains one of the major infectious diseases worldwide. Adverse reactions are common during TB treatment. Few reports, however, are available on treatment-related acute biliary events (ABEs), such as cholelithiasis, biliary obstruction, acute cholecystitis, and cholangitis. Methods: We first report four pulmonary TB patients who developed ABEs during anti-TB treatment. Abdominal sonography revealed multiple gall stones with dilated intrahepatic ducts in three patients and cholecystitis in one patient. To investigate the incidence of and risk factors for ABEs during anti-TB treatment, we subsequently conducted a nationwide cohort study using the National Health Insurance Research Database of Taiwan. Results: A total of 159,566 pulmonary TB patients were identified from the database between 1996 and 2010, and among them, 195 (0.12%) developed ABEs within 180 days after beginning anti-TB treatment. Logistic regression analysis revealed that the risk factors associated with ABEs are older age (relative risk [RR]: 1.32 [1.21-1.44] per 10-year increment) and diabetes mellitus (RR: 1.59 [1.19-2.13]). Conclusions: Although infrequently encountered, ABEs should be considered among patients with TB who experience abdominal discomfort with hyperbilirubinemia, especially patients who have older age or diabetes. ? 2018 The Author(s).
SDGs
Other Subjects
ethambutol; isoniazid; pyrazinamide; rifampicin; tuberculostatic agent; acute cholecystitis; adult; age distribution; aged; antibiotic therapy; Article; cholangitis; cholelithiasis; cholestasis; clinical study; cohort analysis; controlled study; data base; diabetes mellitus; echography; female; human; incidence; logistic regression analysis; lung tuberculosis; major clinical study; male; national health insurance; risk factor; Taiwan; very elderly; bile duct disease; biliary tract disease; cholangitis; cholelithiasis; factual database; hospital; middle aged; statistical model; tuberculosis; Adult; Aged, 80 and over; Antitubercular Agents; Bile Duct Diseases; Biliary Tract Diseases; Cholangitis; Cholelithiasis; Cohort Studies; Databases, Factual; Hospitals; Humans; Incidence; Logistic Models; Male; Middle Aged; Risk Factors; Taiwan; Tuberculosis
Publisher
BioMed Central Ltd.
Type
journal article