Is histopathological examination sufficient in the diagnosis of Crohn's disease in the case of suspected tuberculosis?

Öz

Tuberculosis and Crohn's disease are chronic diseases affecting similar parts of the gastrointestinal system, and they cannot be differentiated clinically. Histopathological examination of a biopsy remains a gold standard for Crohn's disease, but this procedure may not be sufficient for diagnosis of intestinal tuberculosis. In this study, a 19-year-old patient with intestinal tuberculosis is presented; the diagnosis was made by direct microscopic examination, culture and polymerase chain reaction positivity for tuberculosis in a secondary colonoscopic examination. In all patients admitted with fever, chronic diarrhea and abdominal pain, intestinal tuberculosis should be kept in mind, and microbiological tests should be performed due to the similar clinical findings and same affected parts of the gastrointestinal system, even if histopathological results are compatible with Crohn's disease.

Anahtar Kelimeler

• Crohn's disease, tuberculosis, differentiation, histopathology

Tüberküloz ve Crohn hastalığı ayırımında histopatolojik inceleme yeterli midir?

Öz

Tüberküloz ve Crohn hastalığı, gastrointestinal sistemin benzer bölümlerini etkileyen kronik hastalıklar olup, klinik olarak ayırdedilemezler. Biyopsi materyalinin histopatolojik incelemesi Crohn için, hala altın standart olmasına rağmen, tüberküloz için her zaman yeterli olmayabilir. Bu çalışmada, Crohn hastalığı tanısıyla 4 aydır izlenen ve tekrarlanan kolonoskopide alınan örneğin mikroskobik incelemesinde aside rezistan basil görülmesi, kültür ve polimeraz zincir reaksiyonu pozitişiği ile tanı konulabilen 19 yaşındaki intestinal tüberkülozlu olgu sunulmuştur. Ateş, karın ağrısı, kronik diyare ile başvuran hastalarda barsak biyopsi sonucu Crohn ile uyumlu gelse bile; aynı bölgeyi tutması ve benzer klinikle seyretmesi nedeniyle intestinal tüberküloz akılda tutulmalı ve tanıya yönelik mikrobiyolojik tetkikler mutlaka yapılmalıdır.

Anahtar Kelimeler

• Crohn hastalığı, histopatoloji, intestinal tüberküloz, kolonoskopi, tüberküloz

Kaynakça

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