Difficulties in the differential diagnosis of intestinal tuberculosis and Crohn‘s disease
The differential diagnosis of intestinal tuberculosis and Crohn’s disease is a difficult task for most specialists due to their high similarity in clinical manifestations, instrumental diagnosis and histological pattern.The aim: to consider the clinical and diagnostic features of intestinal tubercul...
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| Format: | Article |
| Language: | Russian |
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Scientific Сentre for Family Health and Human Reproduction Problems
2021-11-01
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| Series: | Acta Biomedica Scientifica |
| Subjects: | |
| Online Access: | https://www.actabiomedica.ru/jour/article/view/3050 |
| _version_ | 1826853246762745856 |
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| author | M. N. Reshetnikov D. V. Plotkin Yu. R. Zyuzya A. A. Volkov O. N. Zuban E. M. Bogorodskaya |
| author_facet | M. N. Reshetnikov D. V. Plotkin Yu. R. Zyuzya A. A. Volkov O. N. Zuban E. M. Bogorodskaya |
| author_sort | M. N. Reshetnikov |
| collection | DOAJ |
| description | The differential diagnosis of intestinal tuberculosis and Crohn’s disease is a difficult task for most specialists due to their high similarity in clinical manifestations, instrumental diagnosis and histological pattern.The aim: to consider the clinical and diagnostic features of intestinal tuberculosis and Crohn’s disease, to show the role of various methods of their diagnosis (CT of the abdominal cavity, CT-enterography, colonoscopy with biopsy).A clinical example shows a case illustrating the difficulties of diagnosing intestinal tuberculosis, initially diagnosed as Crohn’s disease. The features of the course, complex diagnosis and treatment of intestinal tuberculosis and its complications during immunosuppression are demonstrated. At the first stage of treatment, the patient’s data related to CT of the chest organs, colonoscopy and histological examination of biopsy samples were incorrectly interpreted. As a result, a wrong diagnosis of Crohn’s disease was made, and immunosuppressive therapy was prescribed that provoked a generalization of the existing tuberculosis process. Subsequently, repeated surgical interventions were performed for complications of intestinal tuberculosis – perforation of tuberculous ulcers, peritonitis. Based on the analysis of the literature data and our own observation, it is shown that granulomatous inflammation in the study of intestinal biopsies doesn’t always allow us to make a clear diagnosis, first of all, there are intestinal tuberculosis and Crohn’s disease in the differential diagnostic series. The use of histobacterioscopy according to Ziehl – Neelsen, the study of fecal matter by luminescent microscopy, as well as molecular genetic methods for detecting DNA MTB allow us to verify the diagnosis. If Crohn’s disease is misdiagnosed as intestinal tuberculosis, then the prescribed anti-tuberculosis therapy can cause harm and lead to a delay in the underlying disease treatment. The reverse misdiagnosis is potentially more dangerous: if tuberculosis is misdiagnosed as Crohn’s disease, then the appointment of immunosuppressive therapy can lead to the generalization of tuberculosis and the development of fatal complications. |
| first_indexed | 2024-03-08T12:16:33Z |
| format | Article |
| id | doaj.art-fb3d320418834e249828360de46d17a0 |
| institution | Directory Open Access Journal |
| issn | 2541-9420 2587-9596 |
| language | Russian |
| last_indexed | 2025-02-16T17:23:24Z |
| publishDate | 2021-11-01 |
| publisher | Scientific Сentre for Family Health and Human Reproduction Problems |
| record_format | Article |
| series | Acta Biomedica Scientifica |
| spelling | doaj.art-fb3d320418834e249828360de46d17a02025-01-27T16:48:59ZrusScientific Сentre for Family Health and Human Reproduction ProblemsActa Biomedica Scientifica2541-94202587-95962021-11-016519621110.29413/ABS.2021-6.5.192225Difficulties in the differential diagnosis of intestinal tuberculosis and Crohn‘s diseaseM. N. Reshetnikov0D. V. Plotkin1Yu. R. Zyuzya2A. A. Volkov3O. N. Zuban4E. M. Bogorodskaya5Moscow Research and Clinical Center for TB Control, Moscow Healthcare DepartmentMoscow Research and Clinical Center for TB Control, Moscow Healthcare DepartmentMoscow Research and Clinical Center for TB Control, Moscow Healthcare DepartmentMoscow Research and Clinical Center for TB Control, Moscow Healthcare DepartmentMoscow Research and Clinical Center for TB Control, Moscow Healthcare DepartmentMoscow Research and Clinical Center for TB Control, Moscow Healthcare DepartmentThe differential diagnosis of intestinal tuberculosis and Crohn’s disease is a difficult task for most specialists due to their high similarity in clinical manifestations, instrumental diagnosis and histological pattern.The aim: to consider the clinical and diagnostic features of intestinal tuberculosis and Crohn’s disease, to show the role of various methods of their diagnosis (CT of the abdominal cavity, CT-enterography, colonoscopy with biopsy).A clinical example shows a case illustrating the difficulties of diagnosing intestinal tuberculosis, initially diagnosed as Crohn’s disease. The features of the course, complex diagnosis and treatment of intestinal tuberculosis and its complications during immunosuppression are demonstrated. At the first stage of treatment, the patient’s data related to CT of the chest organs, colonoscopy and histological examination of biopsy samples were incorrectly interpreted. As a result, a wrong diagnosis of Crohn’s disease was made, and immunosuppressive therapy was prescribed that provoked a generalization of the existing tuberculosis process. Subsequently, repeated surgical interventions were performed for complications of intestinal tuberculosis – perforation of tuberculous ulcers, peritonitis. Based on the analysis of the literature data and our own observation, it is shown that granulomatous inflammation in the study of intestinal biopsies doesn’t always allow us to make a clear diagnosis, first of all, there are intestinal tuberculosis and Crohn’s disease in the differential diagnostic series. The use of histobacterioscopy according to Ziehl – Neelsen, the study of fecal matter by luminescent microscopy, as well as molecular genetic methods for detecting DNA MTB allow us to verify the diagnosis. If Crohn’s disease is misdiagnosed as intestinal tuberculosis, then the prescribed anti-tuberculosis therapy can cause harm and lead to a delay in the underlying disease treatment. The reverse misdiagnosis is potentially more dangerous: if tuberculosis is misdiagnosed as Crohn’s disease, then the appointment of immunosuppressive therapy can lead to the generalization of tuberculosis and the development of fatal complications.https://www.actabiomedica.ru/jour/article/view/3050intestinal tuberculosiscrohn’s diseasecolonoscopygranulomact enterographyimmunosuppression |
| spellingShingle | M. N. Reshetnikov D. V. Plotkin Yu. R. Zyuzya A. A. Volkov O. N. Zuban E. M. Bogorodskaya Difficulties in the differential diagnosis of intestinal tuberculosis and Crohn‘s disease Acta Biomedica Scientifica intestinal tuberculosis crohn’s disease colonoscopy granuloma ct enterography immunosuppression |
| title | Difficulties in the differential diagnosis of intestinal tuberculosis and Crohn‘s disease |
| title_full | Difficulties in the differential diagnosis of intestinal tuberculosis and Crohn‘s disease |
| title_fullStr | Difficulties in the differential diagnosis of intestinal tuberculosis and Crohn‘s disease |
| title_full_unstemmed | Difficulties in the differential diagnosis of intestinal tuberculosis and Crohn‘s disease |
| title_short | Difficulties in the differential diagnosis of intestinal tuberculosis and Crohn‘s disease |
| title_sort | difficulties in the differential diagnosis of intestinal tuberculosis and crohn s disease |
| topic | intestinal tuberculosis crohn’s disease colonoscopy granuloma ct enterography immunosuppression |
| url | https://www.actabiomedica.ru/jour/article/view/3050 |
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