Clinical and laboratory features of intestinal tuberculosis
Bhumit Patel,1 Vipul D Yagnik2 1Department of Medical Gastroenterology, Akshar Bhoomi Liver and Gastro Care, Ahmedabad, Gujarat, India; 2Department of Surgical Gastroenterology, Ronak Endo-laparoscopy and General Surgical Hospital, Patan, Gujarat, India Background/aims: As increasing numbers of Croh...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2018-03-01
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| Series: | Clinical and Experimental Gastroenterology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/clinical-and-laboratory-features-of-intestinal-tuberculosis-peer-reviewed-article-CEG |
| _version_ | 1818306628895637504 |
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| author | Patel B Yagnik VD |
| author_facet | Patel B Yagnik VD |
| author_sort | Patel B |
| collection | DOAJ |
| description | Bhumit Patel,1 Vipul D Yagnik2 1Department of Medical Gastroenterology, Akshar Bhoomi Liver and Gastro Care, Ahmedabad, Gujarat, India; 2Department of Surgical Gastroenterology, Ronak Endo-laparoscopy and General Surgical Hospital, Patan, Gujarat, India Background/aims: As increasing numbers of Crohn’s disease (CD) cases are being recognized in India, so the differential diagnosis of CD and gastrointestinal tuberculosis (GITB) is becoming increasingly important. If patients are misdiagnosed with GITB, toxicity may result from unnecessary anti-TB therapy and treatment of the primary disease (ie, CD) gets delayed. We therefore aimed to assess the accuracy of various parameters that can be used to predict GITB diagnosis at index evaluation.Materials and methods: This was a prospective, unicentric, observational study carried out in the gastroenterology department of a tertiary care hospital between August 2011 and January 2013. Patients who presented to our hospital and were suspected of having GITB were included in our study. Patients were then followed up over a 6-month period.Statistical analysis: Chi-square test was used to analyze the data.Results: Of the 69 patients with GITB, 49 (71.01%) had thickening of the involved part of the colon and 33 (47.83%) had abdominal lymphadenopathy. The ileocecal valve was involved in 58 patients (84.05%) Histological detection of granulomas had 78.95% specificity, 36.23% sensitivity, and 51.40% accuracy. Tuberculosis polymerase chain reaction was found to have 78.95% specificity, 71.01% sensitivity, and 73.83% accuracy. BACTEC-MGIT culture was found to have 100% specificity, 20.29% sensitivity, and 48.60% accuracy.Conclusion: Although histology is helpful in ruling out other conditions, TB-specific findings such as caseating granuloma and acid-fast bacilli are rarely seen. Instead, tuberculosis polymerase chain reaction has the highest diagnostic accuracy followed by BACTEC culture. Keywords: gastrointestinal tuberculosis, colonoscopy, TB polymerase chain reaction, BACTEC culture, antituberculous treatment, biopsy |
| first_indexed | 2024-12-13T06:45:31Z |
| format | Article |
| id | doaj.art-fa6552399a4e4306a4b180b2e8fcdfd6 |
| institution | Directory Open Access Journal |
| issn | 1178-7023 |
| language | English |
| last_indexed | 2024-12-13T06:45:31Z |
| publishDate | 2018-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical and Experimental Gastroenterology |
| spelling | doaj.art-fa6552399a4e4306a4b180b2e8fcdfd62022-12-21T23:56:18ZengDove Medical PressClinical and Experimental Gastroenterology1178-70232018-03-01Volume 119710337177Clinical and laboratory features of intestinal tuberculosisPatel BYagnik VDBhumit Patel,1 Vipul D Yagnik2 1Department of Medical Gastroenterology, Akshar Bhoomi Liver and Gastro Care, Ahmedabad, Gujarat, India; 2Department of Surgical Gastroenterology, Ronak Endo-laparoscopy and General Surgical Hospital, Patan, Gujarat, India Background/aims: As increasing numbers of Crohn’s disease (CD) cases are being recognized in India, so the differential diagnosis of CD and gastrointestinal tuberculosis (GITB) is becoming increasingly important. If patients are misdiagnosed with GITB, toxicity may result from unnecessary anti-TB therapy and treatment of the primary disease (ie, CD) gets delayed. We therefore aimed to assess the accuracy of various parameters that can be used to predict GITB diagnosis at index evaluation.Materials and methods: This was a prospective, unicentric, observational study carried out in the gastroenterology department of a tertiary care hospital between August 2011 and January 2013. Patients who presented to our hospital and were suspected of having GITB were included in our study. Patients were then followed up over a 6-month period.Statistical analysis: Chi-square test was used to analyze the data.Results: Of the 69 patients with GITB, 49 (71.01%) had thickening of the involved part of the colon and 33 (47.83%) had abdominal lymphadenopathy. The ileocecal valve was involved in 58 patients (84.05%) Histological detection of granulomas had 78.95% specificity, 36.23% sensitivity, and 51.40% accuracy. Tuberculosis polymerase chain reaction was found to have 78.95% specificity, 71.01% sensitivity, and 73.83% accuracy. BACTEC-MGIT culture was found to have 100% specificity, 20.29% sensitivity, and 48.60% accuracy.Conclusion: Although histology is helpful in ruling out other conditions, TB-specific findings such as caseating granuloma and acid-fast bacilli are rarely seen. Instead, tuberculosis polymerase chain reaction has the highest diagnostic accuracy followed by BACTEC culture. Keywords: gastrointestinal tuberculosis, colonoscopy, TB polymerase chain reaction, BACTEC culture, antituberculous treatment, biopsyhttps://www.dovepress.com/clinical-and-laboratory-features-of-intestinal-tuberculosis-peer-reviewed-article-CEGGastrointestinal tuberculosisColonoscopyTB polymerase chain reactionBACTEC cultureantituberculous treatmentBiopsy. |
| spellingShingle | Patel B Yagnik VD Clinical and laboratory features of intestinal tuberculosis Clinical and Experimental Gastroenterology Gastrointestinal tuberculosis Colonoscopy TB polymerase chain reaction BACTEC culture antituberculous treatment Biopsy. |
| title | Clinical and laboratory features of intestinal tuberculosis |
| title_full | Clinical and laboratory features of intestinal tuberculosis |
| title_fullStr | Clinical and laboratory features of intestinal tuberculosis |
| title_full_unstemmed | Clinical and laboratory features of intestinal tuberculosis |
| title_short | Clinical and laboratory features of intestinal tuberculosis |
| title_sort | clinical and laboratory features of intestinal tuberculosis |
| topic | Gastrointestinal tuberculosis Colonoscopy TB polymerase chain reaction BACTEC culture antituberculous treatment Biopsy. |
| url | https://www.dovepress.com/clinical-and-laboratory-features-of-intestinal-tuberculosis-peer-reviewed-article-CEG |
| work_keys_str_mv | AT patelb clinicalandlaboratoryfeaturesofintestinaltuberculosis AT yagnikvd clinicalandlaboratoryfeaturesofintestinaltuberculosis |