Important Pathology In The Differential Diagnosis of Crohn's Disease: Tuberculosis Ileocolitis

Yıl 2019, Cilt: 1 Sayı: 3, 105 - 107, 31.12.2019

Uğur Ergün , Gülhan Zorgör Uçdu , Ahmet Ürk , Merve Nur Ak , Erkan Çağlar

Öz

Tuberculosis is an infectious disease that is
the one of the common causes of morbidity and mortality in developing
countries. It has two forms as primary and secondary. The secondary form is
quite rare and should be considered in differential diagnosis of some other
diseases (1).Especially, intestinal tuberculosis (ITB) can be difficult to
distinguish from Crohn’s Disease which is an inflammatory bowel disease. ITB is
a disease that can affect gastrointestinal system and histopathologically
characterized by caseating granulomas. Clinical suspicion has a primary
importance in diagnosis. Early diagnosis is crucial for better prognosis and
lower rates of relapses.

A 38 year old female patient who had
ileocolitis revealed by colonoscopy, was hospitalized for abdominal
non-spesific symptoms with Crohn’s pre-diagnosis. After clinical examination she
was diagnosed with ITB and systemic medical anti tuberculosis therapy was
initiated. Regression of symptoms and signs strengthened our diagnosis. We
present a case emphasizing that ITB should be considered in differential
diagnosis of other causes of ileocolitis, specially Crohn’s disease.

Anahtar Kelimeler

Crohn’s, ileocolitis, intestinal tuberculosis

Kaynakça

• Referans 1. Öksüz P, Ünçel M, Albayrak H, et al. Intestinal tuberculosis can be easily misdiagnosed as Crohn’s Disease. J Tepecik Educ Res Hosp. 2017;27(486):243-245.
• Referans 2. Patel N, Ondhia C, Ahmed S. Bowel obstruction caused by intestinal tuberculosis: an update. Case Reports. 2011.
• Referans 3. Niriella MA, Kodisinghe SK, De Silva AP, Hewavisenthi J, De Silva HJ. Intestinal tuberculosis masquerading as difficult to treat Crohn disease: A case report. BMC Res Notes. 2016;9(1):9-11.
• Referans 4. Wu YF, Ho CM, Yuan CT, Chen CN. Intestinal tuberculosis previously mistreated as Crohn’s disease and complicated with perforation: a case report and literature review. Springerplus. 2015;4(1):1-5.
• Referans 5. Al‐Quorain AA, Facharzt, Satti MB, Al‐Freihi HM, Al‐Gindan YM, Al‐Awad N. Abdominal Tuberculosis in Saudi Arabia: A Clinicopathological Study of 65 Cases. Am J Gastroenterol. 1993.
• Referans 6. Kapoor VK. Classic diseases revisited Abdominal tuberculosis. Postgr MedJ. 1998.
• Referans 7. Petrosyan M, Mason RJ. Tuberculous enteritis presenting as small-bowel obstruction. Clin Gastroenterol Hepatol. 2006.
• Referans 8. García-Díaz RA, Ruiz-Gómez JL, Rodríguez-Sanjuan JC, et al. Perforation of the colon caused by intestinal tuberculosis. Dis Colon Rectum 2006; 49:927; author reply 927.
• Referans 9. Ha HK, Ko GY, Yu ES, et al. Intestinal tuberculosis with abdominal complications: radiologic and pathologic features. Abdom Imaging 1999; 24:32.
• Referans 10. Almadi MA, Ghosh S, Aljebreen AM. Differentiating intestinal tuberculosis from crohn’s disease: A diagnostic challenge. Am J Gastroenterol. 2009;104(4):1003-1012.
• Referans 11. Amarapurkar DN, Patel ND, Rane PS. Diagnosis of Crohn’s disease in India where tuberculosis is widely prevalent. World J Gastroenterol. 2008.
• Referans 12. Burke KA, Patel A, Jayaratnam A, Thiruppathy K, Snooks SJ. Diagnosing abdominal tuberculosis in the acute abdomen. Int J Surg. 2014.
• Referans 13. Rathi P, Gambhire P. Abdominal Tuberculosis. J Assoc Physicians India 2016; 64:38.
• Referans 14. Balthazar EJ, Gordon R, Hulnick D. Ileocecal tuberculosis: CT and radiologic evaluation. AJR Am J Roentgenol 1990; 154:499.
• Referans 15. Gan H, Mely M, Zhao J, Zhu L. An Analysis of the Clinical, Endoscopic, and Pathologic Features of Intestinal Tuberculosis. J Clin Gastroenterol. 2016.