Differentiation of Crohn’s disease from intestinal tuberculosis in India in 2010

作     者：Anna Benjamin Pulimood Deepak Narayan Amarapurkar Ujjala Ghoshal Mathew Phillip Cannanore Ganesh Pai Duvvur Nageshwar Reddy Birender Nagi Balakrishna Siddhartha Ramakrishna 

作者机构：Department of Gastrointestinal Sciences Christian Medical College Department of Gastroenterology Bombay Hospital and Medical Research Centre Department of Microbiology Sanjay Gandhi Postgraduate Institute PVS Institute of Digestive Diseases PVS Hospital Department of Gastroenterology and Hepatology Kasturba Medical College Asian Institute of Gastroenterology Hyderabad Andhra Pradesh 500082 India Department of Gastroenterology Postgraduate Institute 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2011年第17卷第4期

页      面：433-443页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Tuberculosis Crohn’s disease Clinical features Endoscopy Serology Enteroscopy Histology Radiology Surgery Therapy 

摘      要：Differentiating intestinal tuberculosis from Crohn’s disease (CD) is an important clinical challenge of considerable therapeutic significance. The problem is of greatest magnitude in countries where tuberculosis continues to be highly prevalent, and where the incidence of CD is increasing. The final clinical diagnosis is based on a combination of the clinical history with endoscopic studies, culture and polymerase chain reaction for Mycobacterium tuberculosis, biopsy pathology, radiological investigations and response to therapy. In a subset of patients, surgery is required and intraoperative findings with pathological study of the resected bowel provide a definitive diagnosis. Awareness of the parameters useful in distinguishing these two disorders in each of the different diagnostic modalities is crucial to accurate decision making. Newer techniques, such as capsule endoscopy, small bowel enteroscopy and immunological assays for Mycobacterium tuberculosis, have a role to play in the differentiation of intestinal tuberculosis and CD. This review presents currently available evidence regarding the usefulness and limitations of all these different modalities available for the evaluation of these two disorders.