A comparison of clinical and pathologic characteristics between Crohn's disease and intestinal tuberculosis
10.3760/cma.j.issn.0578-1426.2009.04.010
- VernacularTitle:克罗恩病与肠结核临床及病理特征的对比研究
- Author:
Qing GU
;
Qin OUYANG
;
Wenyan ZHANG
;
Gandi LI
- Publication Type:Journal Article
- Keywords:
Crohn disease;
Tuberculosis,gastrointestinal;
Diagnosis,differential
- From:
Chinese Journal of Internal Medicine
2009;48(4):291-294
- CountryChina
- Language:Chinese
-
Abstract:
Objective To search for the distinctive diagnostic features of Crohn's disease and intestinal tuberculosis in clinical manifestations with methods widely used clinically.Methods A retrospective study enrolled 33 Crohn's disease and 34 intestinal tuberculosis inpatients in West China Hospital of Sichuan University from 1996 to 2007.The clinical characteristics and key points of differential diagnosis were analyzed.All the pathological sections were studied again.Results The total duration of symptoms in patients with a diagnosis of Crohn's disease was longer than that in patients with intestinal tuberculosis ( P < 0.05 ).The incidence of eolectomy is significantly higher in Crohn' s disease than in intestinal tuberculosis because of intestinal obstruction or undefined diagnosis ( P < 0.05 ).Hematochezia,extra-intestinal manifestation and ileus occurred significantly more in Crohn's disease than in intestinal tuberculosis( P < 0.05 ).Night sweating and hypoalbuminemia occurred significantly more in intestinal tuberculosis than in Crohn's disease( P <0.05 ).The positive rate of serum antibodies to mycobacterium and increased erythrocyte sedimentation rate is higher in intestinal tuberculosis than in Crohn's disease(P < 0.05).Cobblestone sign and fissure-shape ulcers were only found in Crohn's disease,while circular ulcer occurred significantly more in intestinal tuberculosis( P <0.05).The involvement of stomach,jejunum or ileum was significantly more in Crohn's disease than in intestinal tuberculosis( P < 0.05 ).Granulomas were more common in intestinal tuberculosis than in Crohn's disease( P < 0.05 ) and the site of granulomas was valuable for differential diagnosis.In all the Crohn's disease specimens,lymphoid aggregates in the lamina propria or submucosa were significantly more in surgically reseeted specimens than in endoscopic biopsies (P <0.05).Conclusions There are definitely some different features between the two diseases.It is essential to review the whole clinical data of the patient.The frequency of granulomas and the distribution of chronic inflammation are identified as histological parameters that can be used to differentiate tuberculosis and Crolm's disease.
