Intest Res.  2015 Jan;13(1):6-10. 10.5217/ir.2015.13.1.6.

Seminar Report From the 2014 Taiwan Society of Inflammatory Bowel Disease (TSIBD) Spring Forum (May 24th, 2014): Crohn's Disease Versus Intestinal Tuberculosis Infection

Affiliations
  • 1Department of Internal Medicine, Far-Eastern Memorial Hospital, New Taipei, Taiwan.
  • 2Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taiwan. jmwong@ntu.edu.tw
  • 3Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
  • 4Department of Radiology, Far-Eastern Memorial Hospital, New Taipei, Taiwan.
  • 5Department of Pathology and Forensic Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.

Abstract

Since Taiwan is an endemic area for tuberculosis (TB), differential diagnosis between the intestinal TB and Crohn's disease is an important issue. The steering committee of Taiwan Society of Inflammatory Bowel Disease (TSIBD) has arranged a seminar accordingly on May 24th, 2014 and the different point of views by gastroenterologist, radiologist, pathologist and infectious disease specialist were suggested to help the proper diagnosis and management of these two diseases.

Keyword

Crohn disease; Tuberculosis, intestine

MeSH Terms

Communicable Diseases
Crohn Disease*
Diagnosis
Diagnosis, Differential
Inflammatory Bowel Diseases*
Specialization
Taiwan*
Tuberculosis*

Figure

  • Fig. 1 Abdominal CT finding. Symmetric and concentric wall thickening, with transmural enhancement of terminal ileum of CD.

  • Fig. 2 Abdominal CT finding. Multiple short segment stenoses of small bowel in CD (arrow).

  • Fig. 3 Abdominal CT finding. Enterocutaneous fistula of CD.

  • Fig. 4 Abdominal CT findings. (A) The CT image demonstrates bowel wall edema with mural hyperenhancement (arrows). (B) The CT image shows a marked proliferation of fat (*). Extramural disease may present as increased mensenteric vascular stranding (comb sign, arrow head).

  • Fig. 5 Abdominal CT finding. Asymmetric thickening of the bowel wall and large necrotic lymph nodes in the mesentery of intestinal tuberculosis.


Cited by  8 articles

Best practices on immunomodulators and biologic agents for ulcerative colitis and Crohn’s disease in Asia
Choon Jin Ooi, Ida Hilmi, Rupa Banerjee, Sai Wei Chuah, Siew Chien Ng, Shu Chen Wei, Govind K Makharia, Pises Pisespongsa, Min Hu Chen, Zhi Hua Ran, Byong Duk Ye, Dong Il Park, Khoon Lin Ling, David Ong, Vineet Ahuja, Khean Lee Goh, Jose Sollano, Wee Chian Lim, Wai Keung Leung, Raja Affendi Raja Ali, Deng Chyang Wu, Evan Ong, Nazri Mustaffa, Julajak Limsrivilai, Tadakazu Hisamatsu, Suk Kyun Yang, Qin Ouyang, Richard Geary, Janaka H De Silva, Rungsun Rerknimitr, Marcellus Simadibrata, Murdani Abdullah, Rupert WL Leong
Intest Res. 2019;17(3):285-310.    doi: 10.5217/ir.2019.00026.

Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 1: risk assessment
Dong Il Park, Tadakazu Hisamatsu, Minhu Chen, Siew Chien Ng, Choon Jin Ooi, Shu Chen Wei, Rupa Banerjee, Ida Normiha Hilmi, Yoon Tae Jeen, Dong Soo Han, Hyo Jong Kim, Zhihua Ran, Kaichun Wu, Jiaming Qian, Pin-Jin Hu, Katsuyoshi Matsuoka, Akira Andoh, Yasuo Suzuki, Kentaro Sugano, Mamoru Watanabe, Toshifumi Hibi, Amarender S. Puri, Suk-Kyun Yang
Intest Res. 2018;16(1):4-16.    doi: 10.5217/ir.2018.16.1.4.

Evaluation of Xpert MTB/RIF assay performance in the diagnosis of abdominal tuberculosis
Suraj Kumar, Sawan Bopanna, Saurabh Kedia, Pratap Mouli, Rajan Dhingra, Rajesh Padhan, Mikashmi Kohli, Jigyasa Chaubey, Rohini Sharma, Prasenjit Das, S Dattagupta, Govind Makharia, SK Sharma, Vineet Ahuja
Intest Res. 2017;15(2):187-194.    doi: 10.5217/ir.2017.15.2.187.

Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease
Shu-Chen Wei, Ting-An Chang, Te-Hsin Chao, Jinn-Shiun Chen, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tien-Yu Huang, Tzu-Chi Hsu, Chun-Chi Lin, Hung-Hsin Lin, Jen-Kou Lin, Wei-Chen Lin, Yen-Hsuan Ni, Ming-Jium Shieh, I-Lun Shih, Chia-Tung Shun, Yuk-Ming Tsang, Cheng-Yi Wang, Horng-Yuan Wang, Meng-Tzu Weng, Deng-Chyang Wu, Wen-Chieh Wu, Hsu-Heng Yen, Jau-Min Wong
Intest Res. 2017;15(3):266-284.    doi: 10.5217/ir.2017.15.3.266.

Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease
Shu-Chen Wei, Ting-An Chang, Te-Hsin Chao, Jinn-Shiun Chen, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tien-Yu Huang, Tzu-Chi Hsu, Chun-Chi Lin, Hung-Hsin Lin, Jen-Kou Lin, Wei-Chen Lin, Yen-Hsuan Ni, Ming-Jium Shieh, I-Lun Shih, Chia-Tung Shun, Yuk-Ming Tsang, Cheng-Yi Wang, Horng-Yuan Wang, Meng-Tzu Weng, Deng-Chyang Wu, Wen-Chieh Wu, Hsu-Heng Yen, Jau-Min Wong
Intest Res. 2017;15(3):285-310.    doi: 10.5217/ir.2017.15.3.285.

Change in the diagnosis of inflammatory bowel disease: a hospital-based cohort study from Korea
Ho-Su Lee, Jaewon Choe, Hyo Jeong Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Yong Sik Yoon, Chang Sik Yu, Jin-Ho Kim, Suk-Kyun Yang
Intest Res. 2016;14(3):258-263.    doi: 10.5217/ir.2016.14.3.258.

Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023
Hsu-Heng Yen, Jia-Feng Wu, Horng-Yuan Wang, Ting-An Chang, Chung-Hsin Chang, Chen-Wang Chang, Te-Hsin Chao, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tzu-Chi Hsu, Tien-Yu Huang, Tsung-I Hung, Puo-Hsien Le, Chun-Che Lin, Chun-Chi Lin, Ching-Pin Lin, Jen-Kou Lin, Wei-Chen Lin, Yen-Hsuan Ni, Ming-Jium Shieh, I-Lun Shih, Chia-Tung Shun, Tzung-Jiun Tsai, Cheng-Yi Wang, Meng-Tzu Weng, Jau-Min Wong, Deng-Chyang Wu, Shu-Chen Wei
Intest Res. 2024;22(3):213-249.    doi: 10.5217/ir.2023.00050.

Management of Crohn’s disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023
Jia-Feng Wu, Hsu-Heng Yen, Horng-Yuan Wang, Ting-An Chang, Chung-Hsin Chang, Chen-Wang Chang, Te-Hsin Chao, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tzu-Chi Hsu, Tien-Yu Huang, Tsung-I Hung, Puo-Hsien Le, Chun-Che Lin, Chun-Chi Lin, Ching-Pin Lin, Jen-Kou Lin, Wei-Chen Lin, Yen-Hsuan Ni, Ming-Jium Shieh, I-Lun Shih, Chia-Tung Shun, Tzung-Jiun Tsai, Cheng-Yi Wang, Meng-Tzu Weng, Jau-Min Wong, Deng-Chyang Wu, Shu-Chen Wei
Intest Res. 2024;22(3):250-285.    doi: 10.5217/ir.2024.00060.


Reference

1. Wei SC, Lin MH, Tung CC, et al. A nationwide population-based study of the inflammatory bowel diseases between 1998 and 2008 in Taiwan. BMC Gastroenterol. 2013; 13:166. PMID: 24314308.
2. Fourie PB, Swanevelder JP, Lancaster J. Diagnostic efficiency of the disposable Monotest in detecting tuberculosis infection by setting objective-specific cut-off points for positivity. S Afr Med J. 1996; 86:151–154. PMID: 8619141.
3. Lee YJ, Yang SK, Byeon JS, et al. Analysis of colonoscopic findings in the differential diagnosis between intestinal tuberculosis and Crohn's disease. Endoscopy. 2006; 38:592–597. PMID: 16673312.
4. Almadi MA, Ghosh S, Aljebreen AM. Differentiating intestinal tuberculosis from Crohn's disease: a diagnostic challenge. Am J Gastroenterol. 2009; 104:1003–1012. PMID: 19240705.
5. al Karawi MA, Mohamed AE, Yasawy MI, et al. Protean manifestation of gastrointestinal tuberculosis: report on 130 patients. J Clin Gastroenterol. 1995; 20:225–232. PMID: 7797832.
6. Leung VK, Law ST, Lam CW, et al. Intestinal tuberculosis in a regional hospital in Hong Kong: a 10-year experience. Hong Kong Med J. 2006; 12:264–271. PMID: 16912352.
7. Boudiaf M, Zidi SH, Soyer P, et al. Tuberculous colitis mimicking Crohn's disease: utility of computed tomography in the differentiation. Eur Radiol. 1998; 8:1221–1223. PMID: 9724443.
8. Hisabe T, Hirai F, Matsui T, Watanabe M. Evaluation of diagnostic criteria for Crohn's disease in Japan. J Gastroenterol. 2014; 49:93–99. PMID: 23546557.
9. Kim KM, Lee A, Choi KY, Lee KY, Kwak JJ. Intestinal tuberculosis: clinicopathologic analysis and diagnosis by endoscopic biopsy. Am J Gastroenterol. 1998; 93:606–609. PMID: 9576456.
10. Kirsch R, Pentecost M, Hall Pde M, Epstein DP, Watermeyer G, Friederich PW. Role of colonoscopic biopsy in distinguishing between Crohn's disease and intestinal tuberculosis. J Clin Pathol. 2006; 59:840–844. PMID: 16873564.
11. Makharia GK, Srivastava S, Das P, et al. Clinical, endoscopic, and histological differentiations between Crohn's disease and intestinal tuberculosis. Am J Gastroenterol. 2010; 105:642–651. PMID: 20087333.
12. Menzies D, Pai M, Comstock G. Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research. Ann Intern Med. 2007; 146:340–354. PMID: 17339619.
13. Horsburgh CR Jr, Rubin EJ. Clinical practice. Latent tuberculosis infection in the United States. N Engl J Med. 2011; 364:1441–1448. PMID: 21488766.
Full Text Links
  • IR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr