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High Accuracy of a Simplified, Practical Algorithm in Differentiating Crohn's Disease from Intestinal Tuberculosis
Ida Normiha Hilmi1,2, Nik Arsyad Nik Muhamad Affendi2,3, Shahreedhan Shahrani2
1Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
Differentiating intestinal tuberculosis (ITB) and Crohn's disease (CD) is challenging. A standardized protocol accurately diagnosed CD versus ITB in 89.6% of patients initially, aiding correct treatment.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Immunology
Background:
- Distinguishing intestinal tuberculosis (ITB) from Crohn's disease (CD) poses a diagnostic challenge, especially in tuberculosis-endemic regions.
- Prior research has identified specific features that suggest either ITB or CD.
Purpose of the Study:
- To evaluate the accuracy of a standardized protocol for the initial diagnosis differentiating Crohn's disease (CD) from intestinal tuberculosis (ITB).
Main Methods:
- A prospective study involving patients with suspected ITB or CD.
- A standardized protocol including patient history, ileocolonoscopy with biopsies, and tuberculosis workup was applied.
- Diagnosis was confirmed or revised through clinical, biochemical, and endoscopic reassessment.
Main Results:
- Out of 164 patients, 30 had ITB (18.3%) and 134 had CD (81.7%).
- The protocol achieved an initial diagnostic accuracy of 89.6% (147/164).
- All patients received correct diagnoses by 12 weeks post-reassessment.
Conclusions:
- Crohn's disease was more prevalent than intestinal tuberculosis in this study population.
- The standardized protocol demonstrated high accuracy in differentiating between CD and ITB.
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