Clinical and endoscopic evaluation of anti-tuberculosis trial for differentiation between intestinal tuberculosis and Crohn's disease
10.3760/cma.j.issn.1007-5232.2011.08.009
- VernacularTitle:试验性抗结核治疗鉴别肠结核与克罗恩病的临床与内镜分析
- Author:
Xiang GAO
;
Yao HE
;
Yujun CHEN
;
Yinglian XIAO
;
Baili CHEN
;
Rongping YANG
;
Minhu CHEN
;
Pinjin HU
- Publication Type:Journal Article
- Keywords:
Tuberculosis,gastrointestinal;
Crohn disease;
Antitubercular;
Differential
- From:
Chinese Journal of Digestive Endoscopy
2011;28(8):446-451
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the evaluation standard and proper time point of anti-tuberculosis trial for differential diagnosis between intestinal tuberculosis (ITB) and Crohn's disease (CD). Methods Clinical data and endoscopic changes of 28 patients with confirmed ITB and 11 with confirmed CD,who underwent anti-tuberculosis trail, were retrospectively analyzed. Results No significant difference could be found in clinical characteristics of ITB and CD patients on baseline, such as active pulmonary tuberculosis, strong positive skin test and anal fistula/perianal abscess. Clinical symptoms were relieved in both groups right after anti-tuberculosis treatment. After 3 months of treatment, the no-improvement rate in ITB group was 0, whereas that of CD group was 27.3% (P =0. 004). The disappearance rate plus improvement rate of ulcer in ITB group was 90. 9% (20/22) plus 9. 1% (2/22) and 100% ( 28/28 ) plus 0 at 3 and 6 months of treatment, respectively. The disappearance rate plus improvement rate of nodular lesion was 58. 8% (10/17) plus 41.2% (7/17) and 76. 5% (13/17) plus 23.5% (4/17), respectively. There was no obvious improvement of active ulcer or nodular transformation in CD group at any time point ( P ＜ 0. 01 ).Conclusion With deficiency of special index for differential diagnosis of ITB and CD, some cases hard to differentiate still have to accept anti-tuberculosis treatment. Three months of anti-tuberculosis treatment is a proper time point to evaluate the efficacy. Disappearance of active ulcer and nodular transformation, together with cure or obvious improvement in clinic are taken as effective for treatment trail.
