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 journalArticlepeer-review

2 Citations (Scopus)


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.

Original languageEnglish
Article number64
JournalBMC Infectious Diseases
Issue number1
Publication statusPublished - Feb 1 2018


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

ASJC Scopus subject areas

  • Infectious Diseases


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