COLONIC TUBERCULOSIS VERSUS CROHN’S DISEASE. CASE REPORT AND REVIEW OF THE LITERATURE
A 24-year-old female patient was admitted to our hospital, with a 3 months history of abdominal pain, 3 to 4 bloody stools per day, low grade fever, anorexia and weight loss. Physical examination revealed sub crepitant basilar rales and abdominal pain at medium compression. Laboratory examination identified mild anemia and an inflammatory syndrome. Colonoscopy revealed two large rectal ulcers at 4 cm above the anal verge, from which biopsy specimens were taken, and several other smaller ulcers, in rectum and sigmoid colon. The histological examination identified acid-fast-bacilli (AFB) and granulomatous inflammation. Computed tomography, chest X-ray, sputum smear for AFB and QuantiFeron test, suggested pulmonary and colonic tuberculosis (TB). After 6 months of directly observed therapy for TB, a repeat colonoscopy was performed which showed a scar at 4 cm above the anal verge at the place of the previously described largest ulcer and no other macroscopic changes in rectum and sigmoid were found.
2. Dasgupta A, Singh N, Bhatia A. Abdominal tuberculosis: a histopathological study with special refer-ence to intestinal perforation and mesenteric vasculopathy. J Lab Physicians 2009; 1(2): 56-61.
3. Cheng L, Huang MF, Mei PF, Bo WH, Deng CS. The clinical, endoscopic and pathologic features of Crohn’s disease in the differentiation from intestinal tuberculosis. Zhonghua Nei Ke Za Zhi 2013; 52: 940-944.
4. Almadi MA, Ghosh S, Aljebreen AM. Differentiating intestinal tuberculosis from Crohn’s disease: a diagnostic challenge. Am J Gastroenterol 2009; 104(4): 1003-1012.
5. Dutta AK, Sahu MK, Gangadharan SK, Chacko A. Distinguishing Crohn’s disease from intestinal tuberculosis--a prospective study. Trop Gastroenterol 2011; 32(3): 204-209.
6. Huang X, Liao WD, Yu C, et al. Differences in clinical features of Crohn’s disease and intestinal tuberculosis. World J Gastroenterol 2015; 21(12): 3650-3656.
7. Yadav DP, Madhusudhan KS, Kedia S, et al. Development and validation of visceral fat quantification as a surrogate marker for differentiation of Crohn’s disease and intestinal tuberculosis. J Gastroenterol Hepatol 2017; 32(2): 420-426.
8. Mukewar S, Mukewar S, Ravi R, Prasad A, S Dua K. Colon tuberculosis: endoscopic features and prospective endoscopic follow-up after anti-tuberculosis treatment. Clin Transl Gastroenterol 2012; 3(10): e24.
9. Lei Y, Yi FM, Zhao J, et al. Utility of in vitro interferon-γ release assay in differential diagnosis between intestinal tuberculosis and Crohn’s disease. J Dig Dis 2013; 14(2): 68-75.
10. Larsson G, Shenoy T, Ramasubramanian R, et al. Routine diagnosis of intestinal tuberculosis and Crohn’s disease in Southern India. World J Gastroenterol 2014; 20(17): 5017-5024.
11. Jung Y, Hwangbo Y, Yoon SM, et al. Predictive Factors for Differentiating Between Crohn’s Disease and Intestinal Tuberculosis in Koreans. Am J Gastroenterol 2016; 111(8): 1156-1164.
12. Makharia GK, Srivastava S, Das P, et al. Clinical, endoscopic, and histological differentiations between Crohn’s disease and intestinal tuberculosis. Am J Gastroenterol 2010; 105(3): 642-651.
13. Amarapurkar DN, Patel ND, Amarapurkar AD, Agal S, Baigal R, Gupte P. Tissue polymerase chain reaction in diagnosis of intestinal tuberculosis and Crohn’s disease. J Assoc Physicians India 2004; 52: 863-867.
14. Fei BY, Lv HX, Zheng WH. Fluorescent quantitative PCR of Mycobacterium tuberculosis for differ-entiating intestinal tuberculosis from Crohn’s disease. Braz J Med Biol Res 2014; 47(2): 166-170.
15. Zhao XS, Wang ZT, Wu ZY, et al. Differentiation of Crohn’s disease from intestinal tuberculosis by clinical and CT enterographic models. Inflamm Bowel Dis 2014; 20(5): 916-925.
16. Yu H, Liu Y, Wang Y, Peng L, Li A, Zhang Y. Clinical, endoscopic and histological differentiations between Crohn’s disease and intestinal tuberculosis. Digestion 2012; 85(3): 202-209.
17. Alvares JF, Devarbhavi H, Makhija P, Rao S, Kottoor R. Clinical, colonoscopic, and histological profile of colonic tuberculosis in a tertiary hospital. Endoscopy 2005; 37(4): 351-356.
18. Misra SP, Misra V, Dwivedi M, Arora JS, Kunwar BK. Tuberculous colonic strictures: impact of dilation on diagnosis. Endoscopy 2004; 36(12): 1099-1103.
19. Octoratou M, Merikas E, Malgarinos G, Stanciu C, Triantafillidis JK. A prospective study of pre-illness diet in newly diagnosed patients with Crohn’s disease. Rev Med Chir Soc Med Nat Iasi 2012; 116(1): 40-49.
20. Limsrivilai J, Shreiner AB, Pongpaibul A, et al. Meta-analytic Bayesian model for differentiating intestinal tuberculosis from Crohn’s disease. Am J Gastroenterol 2017; 112(3): 415-427.
21. Misra SP, Misra V, Dwivedi M, Gupta SC. Colonic tuberculosis: clinical features, endoscopic ap-pearance and management. J Gastroenterol Hepatol 1999; 14(7): 723-729.
22. Ouyang Q, Tandon R, Goh KL, Ooi CJ, Ogata H, Fiocchi C. The emergence of inflammatory bowel disease in the Asian Pacific region. Curr Opin Gastroenterol 2005; 21(4): 408-413.
23. Patel B, Yagnik VD. Clinical and laboratory features of intestinal tuberculosis. Clin Exp Gastroenterol 2018; 11: 97-103.
24. Singeap AM, Trifan A, Cojocariu C, Sfarti C, Stanciu C. Rolul videocapsulei endoscopice în boala Crohn suspectată. Rev Med Chir Soc Med Nat Iasi 2011; 115(2): 375-379.
25. Villanueva SE, Martinez HMP, Fernando ATFJ, Valdés OM. Colonic tuberculosis. Dig Dis Sci 2002; 47(9): 2045-2048.
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.
COPYRIGHT TRANSFER FORM FOR
REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /
THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI
We, the undersigned authors of the manuscript entitled
warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.
- we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
- the manuscript does not break the intellectual property rights of any other person.
- we have read the submitted version of the manuscript and we are fully responsible for the content.
Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):
N.B. All the authors must sign this form