So-called primary ulcerohypertrophic ileocecal tuberculosis

Paustian, Frederick F.; Bockus, Henry L.

doi:10.1016/0002-9343(59)90016-6

Cited by 85 publications

(36 citation statements)

References 16 publications

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“…The hypertrophic form seldom satisfies all of these criteria, but if one of them is met, a positive diagnosis is made. 123 The diagnosis of the hypertrophic form differs in the site of the caseous necrosis; it occurs in the draining lymph nodes rather than in the intestinal tissue and culture of M . tuberculosis was achieved in only one-third of the cases e~a m i n e d .~~~"~~ Caseous necrosis was rarely observed in the culture-positive cases.…”

Section: Gut Disorders Associated With Mycobacteria In Manmentioning

confidence: 99%

The role of mycobacteria in Crohn's disease

Thompson¹

1994

Journal of Medical Microbiology

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Section: Gut Disorders Associated With Mycobacteria In Manmentioning

confidence: 99%

The role of mycobacteria in Crohn's disease

Thompson¹

1994

Journal of Medical Microbiology

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“…Others have disagreed (40,128,131,219,269,287), and if we accept M. tuberculosis as a strict pathogen, then hypertrophic intestinal tuberculosis without caseation necrosis or demonstrable acid-fast bacilli does exist. Paustian and Bockus (219) established that at least one of their four criteria is needed to make a diagnosis of intestinal tuberculosis: (i) positive culture or guinea pig disease after inoculation; (ii) microscopic demonstration of acid-fast bacilli in tissues; (iii) presence of tubercles with caseation in diseased tissue; or (iv) caseous granulomata in draining lymph nodes. All of these criteria are seldom satisfied in hypertrophic tuberculosis, but at least one is generally accepted as sufficient for diagnosis (219 (297) were successful in cultivating organisms in only 26 (35%) of the 69 cases of hypertrophic tuberculosis they examined.…”

Section: Similarities Between Crohn's Disease and Other Mycobacterialmentioning

confidence: 99%

“…Paustian and Bockus (219) established that at least one of their four criteria is needed to make a diagnosis of intestinal tuberculosis: (i) positive culture or guinea pig disease after inoculation; (ii) microscopic demonstration of acid-fast bacilli in tissues; (iii) presence of tubercles with caseation in diseased tissue; or (iv) caseous granulomata in draining lymph nodes. All of these criteria are seldom satisfied in hypertrophic tuberculosis, but at least one is generally accepted as sufficient for diagnosis (219 (297) were successful in cultivating organisms in only 26 (35%) of the 69 cases of hypertrophic tuberculosis they examined. In other cases, diagnosis was made based on the presence of caseation necrosis of the diseased tissues.…”

Section: Similarities Between Crohn's Disease and Other Mycobacterialmentioning

confidence: 99%

Crohn's disease and the mycobacterioses: a review and comparison of two disease entities

1989

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Crohn's disease is a chronic granulomatous ileocolitis, of unknown etiology, which generally affects the patient during the prime of life. Medical treatment is supportive at best, and patients afflicted with this disorder generally live with chronic pain, in and out of hospitals, throughout their lives. The disease bears the name of the investigator who convincingly distinguished this disease from intestinal tuberculosis in 1932. This distinction was not universally accepted, and the notion of a mycobacterial etiology has never been fully dismissed. Nevertheless, it was 46 years after the distinction of Crohn's disease and intestinal tuberculosis before research attempting to reassociate mycobacteria and Crohn's disease was published. Recently, there has been a surge of interest in the possible association of mycobacteria and Crohn's disease due largely to the isolation of genetically identical pathogenic Mycobacterium paratuberculosis from several patients with Crohn's disease in the United States, the Netherlands, Australia, and France. These pathogenic organisms have been isolated from only a few patients, and direct evidence for their involvement in the disease process is not clear; however, M. paratuberculosis is an obligate intracellular organism and strict pathogen, which strongly suggests some etiologic role. Immunologic evidence of a mycobacterial etiology, as assessed by humoral immune determinations, has been conflicting, but evaluation of the more relevant cellular immunity has not been performed. Data from histochemical searches for mycobacteria in Crohn's disease tissues have been equally conflicting, with acid-fast bacilli detected in 0 to 35% of patients. Animal model studies have demonstrated the pathogenic potential of isolates as well as elucidated the complexity of mycobacterial-intestinal interactions. Treatment of Crohn's disease patients with antimycobacterial agent has not been fully assessed, although case reports suggest efficacy. The similarities in the pathology, epidemiology, and chemotherapy of Crohn's disease and the mycobacterioses are discussed. The issue is fraught with controversy, and the data generated on the association of mycobacteria and Crohn's disease are in their infantile stages so that a general conclusion on the legitimacy of this association cannot be made. While no firm evidence clearly implicates mycobacteria as an etiologic agent of Crohn's disease, the notion is supported by suggestive and circumstantial evidence and a remarkable similarity of Crohn's disease to known mycobacterial diseases.

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“…The majority of pathogens most commonly affect the ileum 22,68 . Ninety percent of TB occurs in the ileum or cecum due to the stasis and lymphatic abundance 69 . Ileal TB usually results in asymmetric wall thickening in the ileum and multiple large low density/necrotic nodes on CT 68,70 .…”

Section: Possible Mesenteric Ischemiamentioning

confidence: 99%