<s>[INST] I am 70 year old end stage of renal disease my biopsy from clavicle was necrotising granulomatous inflammation suggestive of TB, XPert PCR and special stains for TB were not positive, however Quantiferon Gold was positive for TB on ATT but liver enzymes gets elevated frequently urine output is also decreasing please advise [/INST] HIThank for asking to HCMSome time clinical symptoms are very important rather than the lab. reports I have seen many cases in which the lab. reports was very bad but patient does not have any clinical symptoms related with the reports and they are really doing fine, so I advise you to take it easy if do not have any clinical sing or symptoms then why to worry the value of chemical reaction of our body goes on changing from time to time, keep your moral high every thing will be okay have nice day. </s>