Colonoscopy evaluation after short-term anti-tuberculosis treatment in nonspecific ulcers on the ileocecal area

Park, Sung Chul; Jun, Dae Won; Kim, Seong Hwan; Lee, Han Hyo; Jo, Yun Ju; Song, Moon Hee; Kim, Nam In; Lee, Jung Hoon

doi:10.3748/wjg.14.5051

Cited by 32 publications

(24 citation statements)

References 19 publications

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“…Th is strategy may not always be decisive, as many patients with CD are known to respond to anti-tuberculous drugs at least initially. Th is initial response in them is most likely secondary to the antibiotic eff ect of anti-tubercular drugs, as these patients have been reported to also respond to ciprofl oxacin and metronidazole (38,39) . Despite the initial response to anti-tuberculous therapy, the lesions and symptoms do revert once anti-tubercular drugs are stopped.…”

Section: Discussionmentioning

confidence: 98%

Clinical, Endoscopic, and Histological Differentiations Between Crohn's Disease and Intestinal Tuberculosis

Makharia

Srivastava²,

Das³

et al. 2010

American Journal of Gastroenterology

223

182

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Section: Discussionmentioning

confidence: 98%

Clinical, Endoscopic, and Histological Differentiations Between Crohn's Disease and Intestinal Tuberculosis

Makharia

Srivastava²,

Das³

et al. 2010

American Journal of Gastroenterology

223

182

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“…It has been recommended that suspicious cases of ITB that showing negative PCR and culture results and suspicious cases of CD with positive IGRA results receive anti‐TB therapy . A therapeutic trial of 2–3 months is thought to be appropriate, as clinical and endoscopic improvements can be seen during this period . Hence, treatment response and a subsequent colonoscopy is of critical importance.…”

Section: Therapymentioning

confidence: 99%

“…19 A therapeutic trial of 2-3 months is thought to be appropriate, as clinical and endoscopic improvements can be seen during this period. 64,65 Hence, treatment response and a subsequent colonoscopy is of critical importance. Once the diagnosis of ITB has been confirmed, a full course of treatment is required.…”

Section: Computed Tomographic Enterography Patternsmentioning

confidence: 99%

Intestinal tuberculosis and Crohn's disease: challenging differential diagnosis

Jia¹,

Jin²,

Ran

2016

J of Digest Diseases

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Along with epidemiological changes in tuberculosis (TB) and an increased incidence of Crohn's disease (CD), the differential diagnosis of intestinal TB (ITB) and CD is of vital importance and has become a clinical challenge because treatment based on misdiagnosis may lead to fatal outcomes. In this study, we reviewed the similarities and differences in clinical, endoscopic, radiological and histological features of these two diseases. Concomitant pulmonary TB, ascites, night sweats, involvement of fewer than four segments of the bowel, patulous ileocecal valve, transverse ulcers, scars or pseudopolyps strongly indicate ITB. Bloody stools, perianal signs, chronic diarrhea, extraintestinal manifestations, anorectal lesions, longitudinal ulcers and a cobblestone appearance are all suggestive of CD. Significant differences in the size, number, location and patterns of granulomas in ITB and CD with regard to their histopathologic features have been noted. Immune stain of cell surface markers is also helpful. Interferon-γ release assay and polymerase chain reaction analysis have achieved satisfactory sensitivity and specificity in the diagnosis of ITB. Computed tomography enterographic findings of segmental small bowel or left colon involvement, mural stratification, the comb sign and fibrofatty proliferation are significantly more common in CD, whereas mesenteric lymph node changes (calcification or central necrosis) and focal ileocecal lesions are more frequently seen in ITB. A diagnosis should be carefully established before the initiation of the therapy. In suspicious cases, short-term empirical anti-TB therapy is quite efficient to further confirm the diagnosis.

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“…Çünkü intestinal tüberküloz olan bir hastaya yanlışlıkla Crohn tanısı konularak immünsüpresif tedavinin başlaması disseminasyona neden olarak; tabloyu kötüleştirip durumun morbidite ve mortalitesini arttıracaktır 6 .…”

Section: Discussionunclassified

İntestinal Tüberküloz: Tanısal Zorlukları ile Beraber Nadir Bir Olgu

Çelik¹,

Kayilioglu²,

Akyol³

2015

Cukurova Medical Journal

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ÖZETTüberküloz, artan sıklığı ile ülkemizde hala mortalite ve morbiditenin önemli bir nedenidir. Gastrointestinal sistemin aynı bölümlerini etkilemeleri, ülseratif lezyonlarla seyretmeleri, semptom ve muayene bulgularının benzer olması gibi nedenlerle intestinal tüberküloz ve Crohn hastalığı klinik olarak ayırt edilemeyebilirler. Olguda karın ağrısı nedeniyle hastaneye başvuran ve zorlu tanı aşamalarını takiben intestinal tüberküloz tanısı alan 31 yaşında kadın hasta sunulmuştur. Sadece intestinal bulguları olan hastalarda, Crohn hastalığı düşünülerek verilen antiinflamatuvar ve immünomodülatör tedavi hastalığın ilerlemesine neden olabileceği unutulmamalıdır. Bu nedenle ayrıntılı testlerle intestinal tüberküloz tanısı irdelenmelidir. Anahtar kelimeler: Crohn hastalığı, gastrointestinal, tüberküloz ABSTRACTTuberculosis is an important cause of mortality and morbidity in Turkey with steadily increasing incidence. By effecting the same part of gastrointestinal tract and causing ulserative lessions, symptoms and examination findings, intestinal tuberculosis and Crohn's disease are clinically indistinguishable. In this case, we present a successfully treated case of 31 year old woman with intestinal tuberculosis, despite the diagnostic difficulties. Patients who have only abdominal symptoms may face the risk of getting treated like inflammatory bowel diseases with antiinflammatory and immunomodulator agents which might cause a progression in the disease. Diagnosis of intestinal tuberculosis should be studied carefully.

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Colonoscopy evaluation after short-term anti-tuberculosis treatment in nonspecific ulcers on the ileocecal area

Abstract: Abstract

Cited by 32 publications

References 19 publications

Clinical, Endoscopic, and Histological Differentiations Between Crohn's Disease and Intestinal Tuberculosis

Clinical, Endoscopic, and Histological Differentiations Between Crohn's Disease and Intestinal Tuberculosis

Intestinal tuberculosis and Crohn's disease: challenging differential diagnosis

İntestinal Tüberküloz: Tanısal Zorlukları ile Beraber Nadir Bir Olgu

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