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

Am J Gastroenterol. 2016 Aug;111(8):1156-64. doi: 10.1038/ajg.2016.212. Epub 2016 Jun 14.

Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

MeSH terms

  • 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
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • ROC Curve
  • Radiography, Thoracic
  • Republic of Korea
  • Retrospective Studies
  • 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