Kedia S, Das P, Madhusudhan KS, Dattagupta S, Sharma R, Sahni P, Makharia G, Ahuja V. Differentiating Crohn’s disease from intestinal tuberculosis. World J Gastroenterol 2019; 25(4): 418-432 [PMID: 30700939 DOI: 10.3748/wjg.v25.i4.418]
Corresponding Author of This Article
Saurabh Kedia, MD, Assistant Professor, Department of Gastroenterology, All India Institute of Medical Sciences, Room No 3066, Third Floor, Teaching Block, New Delhi 110029, India. dr.saurabhkedia@aiims.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Saurabh Kedia, Govind Makharia, Vineet Ahuja, Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi 110029, India
Prasenjit Das, Siddhartha Dattagupta, Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India
Kumble Seetharama Madhusudhan, Raju Sharma, Department of Radiology, All India Institute of Medical Sciences, New Delhi 110029, India
Peush Sahni, Department of GI Surgery, All India Institute of Medical Sciences, New Delhi 110029, India
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Saurabh Kedia, MD, Assistant Professor, Department of Gastroenterology, All India Institute of Medical Sciences, Room No 3066, Third Floor, Teaching Block, New Delhi 110029, India. dr.saurabhkedia@aiims.edu
Telephone: +91-11-26546575 Fax: +91-11-26588663
Received: July 26, 2018 Peer-review started: July 26, 2018 First decision: October 8, 2018 Revised: December 7, 2018 Accepted: December 14, 2018 Article in press: December 14, 2018 Published online: January 28, 2019
Core Tip
Core tip: There is a constant challenge of differentiating Crohn’s disease (CD) from intestinal tuberculosis, especially with the increasing burden of inflammatory bowel disease in tuberculosis-endemic areas. Caseation necrosis on biopsy, positive acid-fast bacillus smear/culture, and necrotic lymph node on computed tomography (CT) are the only differentiating features with 100% specificity, though are limited by poor sensitivity. Multi-parametric models have their own limitations and a therapeutic trial of anti-tubercular therapy is often required. Upcoming markers include the latest Bayesian meta-analysis, enumeration of peripheral blood T-regulatory cells, and updated CT based predictive score. Therapeutic trial is associated with a delay in CD diagnosis, and better modalities/biomarkers are required for improved differentiation and reduction in the need for anti-tubercular therapy trial.
