08 July 2026
: Case report 
A 31-Year-Old Woman With Liver Cirrhosis Due to Wilson Disease and the Double Impact of Active Tuberculosis and Anti-Tuberculosis Therapy Resulting in Acute Liver Injury
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Rare disease, Adverse events of drug therapy, Educational Purpose (only if useful for a systematic review or synthesis)
Petar Trifonov ABEF 1,2*, Sonya Stefkova Dragneva ABEF 1,2, Donika K. Todovichin BDF 1,2, Ivana Tihomirova Kitaeva BE 1, Rosen K. Nikolov ADF 1,2DOI: 10.12659/AJCR.953050
Am J Case Rep 2026; 27:e953050
Figure 2 Trend of serum aminotransferases aspartate aminotransferase (AST; reference range 10–40 U/L) and alanine aminotransferase (ALT; reference range 7–40 U/L) across 3 hospital admissionsValues from February 2025 (stable baseline), July 2025 (first acute decompensation with extrapulmonary tuberculosis), and September 2025 (second admission with severe antituberculosis drug-induced liver injury, AT-DILI) are shown. The steep rise in both aminotransferases in September 2025 coincides temporally with the initiation of first-line anti-tuberculosis therapy (rifampicin and isoniazid).