Predictive Factors for Differentiating Between Crohn's Disease and Intestinal Tuberculosis in Koreans

• Published in: The American journal of gastroenterology Vol. 111; no. 8; pp. 1156 - 1164
• Main Authors: Jung, Yunho, Hwangbo, Young, Yoon, Soon Man, Koo, Hoon Sup, Shin, Hyun Deok, Shin, Jeong Eun, Moon, Hee Seok, Kang, Sang Bum, Lee, Jeong Rok, Huh, Kyu Chan
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins 01.08.2016
• Subjects: Abdominal Pain - etiology; Adolescent; Adult; Age Factors; Aged; Anus Diseases - etiology; Colonoscopy; Crohn Disease - complications; Crohn Disease - diagnosis; Crohn Disease - pathology; Diagnosis, Differential; Diarrhea - etiology; Female; Gastroenterology; Humans; Logistic Models; Male; Middle Aged; Mycobacterium; Radiography, Thoracic; Republic of Korea; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Sex Factors; Sigmoid Diseases - etiology; Tuberculosis, Gastrointestinal - complications; Tuberculosis, Gastrointestinal - diagnosis; Tuberculosis, Gastrointestinal - pathology; Tuberculosis, Pulmonary - complications; Tuberculosis, Pulmonary - diagnostic imaging; Ulcer - etiology; Ulcer - pathology; Young Adult
• ISSN: 0002-9270; 1572-0241
• DOI: 10.1038/ajg.2016.212

A differential diagnosis between intestinal tuberculosis (ITB) and Crohn's disease (CD) is challenging. The aim of this study was to investigate the clinical, endoscopic, and histological features and to create a predictive score model for differentiating CD and ITB. In total, 261 patients, 99 with ITB and 162 with CD, were recruited from seven tertiary centers from 2005 to 2013 and reviewed retrospectively. For the creation of a validated model, parameters were selected by univariate logistic regression and receiver operating characteristic curve analyses. Then, the prediction model was established on the basis of β-coefficients of the multivariate logistic regression. For the validation of the model, the same regression equation was tested on the other group. Age, diarrhea, ring-shaped ulcer, longitudinal ulcer, sigmoid involvement, suspicious radiological pulmonary tuberculosis, and gender were selected as the factors for a seven-marker model. In the seven-marker model of the validation data set, the sensitivity, specificity, positive predictive value, and negative predictive value with a cutoff level of 0.35 were 98.0, 92.4, 88.9, and 98.6, respectively. The seven-marker model seems to be highly reliable for differentiating between ITB and CD and could be conveniently used by clinicians to obtain results.