Q: Four months back the doctor removed around 800 ml of water from my lungs. At that time my ESR was 42 and SGPT was under control-22. My SGPT started going up to 910 and is 240 at present. Also, my serum bilirubin is 4 times higher than the normal range. I am taking only cow's milk and fruits. I have stopped AKT. How do I control TB, SGPT and bilirubin levels?

A:It appears from the case details you have provided that you are suffering from ATT induced hepatotoxicity. This is seen in a small proportion of patients taking anti tubercular drugs. In <1% this can became serious. My suggestions for your further treatment are as follows: - 1. Stop ATT but you can take non hepatotoxic drugs such as Ethambutol & Ofloxacin. 2. Re introduce ATT (INH & Rifampicin) one by one once your liver function tests (LFT) became normal. 3. Also check your viral markers such as HBsAg, anti HCV, IgM anti HAV, IgM anti HEV. 4. Get an ultrasound of upper abdomen to look for any other liver problem.