Differentiating Crohn's disease from intestinal tuberculosis.

摘要: Differentiating Crohn's disease (CD) and intestinal tuberculosis (ITB) has remained a dilemma for most of the clinicians in developing world, which are endemic ITB, where burden inflammatory bowel is on rise. Although, there certain clinical (diarrhea/hematochezia/perianal common CD; fever/night sweats ITB), endoscopic (longitudinal/aphthous ulcers transverse ulcers/patulous ileocaecal valve histologic (caseating/confluent/large granuloma ITB; microgranuloma CD), microbiologic (positive stain/culture acid fast-bacillus radiologic (long segment involvement/comb sign/skip lesions necrotic lymph node/contiguous involvement serologic differences between CD only exclusive features caseation necrosis biopsy, positive smear acid-fast bacillus (AFB) and/or AFB culture, node cross-sectional imaging ITB. However, these limited by poor sensitivity, this led to development multiple multi-parametric predictive models. These models also complex formulae, small sample size lack validation across other populations. Several new parameters have come up including latest Bayesian meta-analysis, enumeration peripheral blood T-regulatory cells, updated computed tomography based score. therapeutic anti-tubercular therapy (ATT) trial, subsequent response ATT still required significant proportion patients establish diagnosis. Therapeutic trial associated with delay diagnosis CD, need better modalities improved differentiation reduction trial.