Singh SK, et al. - This trial incorporated the scrutiny of the clinical, endoscopic, radiologic, and histopathological features that assisted in differentiating Crohn's disease (CD) from intestinal tuberculosis (ITB) in children. It was determined that the microbiologic confirmation of tuberculosis was probable in 40% ITB cases. The most significant characteristics favoring CD were discovered to be the presence of blood in stool and left-sided colonic involvement.

Methods

• The eligible candidates included patients diagnosed to have CD or ITB based on standard recommended criteria.
• The exclusion criteria consisted of children with inflammatory bowel disease unclassified or suspected ITB or CD with incomplete work-up or lost to follow-up.
• Researchers inspected the clinical and laboratory (radiology, endoscopy, and histology) details of children.

Results

• A total of 20 patients of ITB (14 [3–17] years) and 23 of CD (11 [1–17] years) were recruited.
• It was found that the presentation with chronic diarrhea (82% vs 40%; P=0.006) and blood in stool (74% vs 10%; P=0.001) favored CD.
• In contrast, subacute intestinal obstruction (20% vs 0%; P=0.04) and ascites (30% vs 0%; P=0.005) favored ITB.
• CD was favored in the presence of deep ulcers (61% vs 30%; P=0.04), longitudinal ulcers (48% vs 15%; P=0.02), involvement of multiple colonic segments (70% vs 35%; P=0.02), left-sided colon (87% vs 40%; P=0.003), extraintestinal manifestations (21.7% vs 0%; P=0.02), and higher platelet count (3.9 vs 2.6 × 105/mm3; P=0.02).
• Findings illustrated that isolated ileocecal involvement (40% vs 8.7%; P=0.03) was a characteristic of ITB.
• In 40% ITB cases TB bacilli were detected (colon-6, ascites-1, abdominal lymph node-1).
• The presence of blood in stool (odds ratio: 37.5 [confidence interval: 3.85-365.72], P=0.002) and left-sided colonic involvement (odds ratio: 16.2 [confidence interval: 1.63–161.98], P=0.02) served as independent predictors of CD, in the multivariate analysis.