Acute biliary events during anti-tuberculosis treatment: Hospital case series and a nationwide cohort study

Lih Yu Chang, Chih Hsin Lee, Chia Hao Chang, Ming Chia Lee, Meng Rui Lee, Jann Yuan Wang, Li Na Lee

Research output: Contribution to journalArticle

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.

LanguageEnglish
Article number64
JournalBMC Infectious Diseases
Volume18
Issue number1
DOIs
Publication statusPublished - Feb 1 2018

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Chronic Disease Hospitals
Tuberculosis
Cohort Studies
Pulmonary Tuberculosis
Therapeutics
Databases
Acute Cholecystitis
Cholecystitis
Cholangitis
Hyperbilirubinemia
Cholelithiasis
National Health Programs
Gallstones
Taiwan
Communicable Diseases
Ultrasonography
Diabetes Mellitus
Logistic Models
Regression Analysis
Incidence

Keywords

  • Biliary event
  • Cholangitis
  • Cholecystitis
  • Cholelithiasis
  • National Health Insurance Research Database
  • Tuberculosis

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Acute biliary events during anti-tuberculosis treatment : Hospital case series and a nationwide cohort study. / Chang, Lih Yu; Lee, Chih Hsin; Chang, Chia Hao; Lee, Ming Chia; Lee, Meng Rui; Wang, Jann Yuan; Lee, Li Na.

In: BMC Infectious Diseases, Vol. 18, No. 1, 64, 01.02.2018.

Research output: Contribution to journalArticle

Chang, Lih Yu ; Lee, Chih Hsin ; Chang, Chia Hao ; Lee, Ming Chia ; Lee, Meng Rui ; Wang, Jann Yuan ; Lee, Li Na. / Acute biliary events during anti-tuberculosis treatment : Hospital case series and a nationwide cohort study. In: BMC Infectious Diseases. 2018 ; Vol. 18, No. 1.
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