Publication Details
Abstract
Chronic drug-resistant tuberculosis (DR-TB) remains a significant global health problem, characterized not only by persistent pulmonary infection but also by systemic organ involvement. Prolonged exposure to second-line anti-tuberculosis therapy and sustained inflammatory activity may induce structural damage in vital organs, particularly the liver and kidneys. This study aimed to investigate histopathological and immunohistochemical alterations in hepatic and renal tissues among patients with chronic DR-TB. A combined retrospective-prospective morphological analysis was conducted using biopsy and autopsy specimens. Histological evaluation was performed with hematoxylin–eosin, Masson’s trichrome, and PAS staining. Immunohistochemical assessment included TNF-α, IL-6, caspase-3, CD68, and α-SMA markers to evaluate inflammation, apoptosis, macrophage infiltration, and fibrosis. The findings revealed hepatocellular dystrophy, steatosis, focal necrosis, and periportal fibrosis in liver tissues, while renal samples demonstrated glomerulosclerosis, tubular degeneration, interstitial inflammation, and early fibrosis. Increased expression of pro-inflammatory cytokines, enhanced apoptotic activity, and activation of fibrotic pathways were observed in both organs. These results indicate that chronic DR-TB induces significant degenerative, inflammatory, and fibrotic changes beyond pulmonary pathology. Morphological monitoring may provide additional value in preventing progressive organ dysfunction during long-term anti-tuberculosis treatment.