A Case of Tuberculous Colitis with Associated Takayasu's Arteritis

Intestinal tuberculosis and Crohn's disease (CD) are two different granulomatous diseases affecting the intestinal tract with similarities in clinical presentation but different therapeutic strategies. Takayasu's arteritis (TA) is a graulomatous disease of aorta and its major branches. TA is associated with tuberculosis as well as CD. We present a case of Granulomatous colitis in a young female who was detected to have TA. She was initially diagnosed as a case of CD elsewhere four years previously and has been on immunosuppressive treatment. Repeat evaluation at our centre using endoscopic, radiological and histological criteria suggested a diagnosis of intestinal tuberculosis which was confirmed both by molecular biology techniques as well as by tissue cultures for mycobacterium tuberculosis. Herein we discuss the diagnostic challenge of distinguishing intestinal tuberculosis and CD in a tuberculous endemic country like India. Recent studies have analysed the immunological mechanisms explaining the association of TA and tuberculosis. These studies are important as they may give a clue for better targeted therapies and out come in TA.