Endoscopic Diagnosis and Differentiation of Inflammatory Bowel Disease

Lee, Ji Min; Lee, Kang Moon

doi:10.5946/ce.2016.090

Cited by 49 publications

(47 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Inflammation in CD is often discontinuous and adjacent to normal tissue, resulting in segmental lesions 10. A cobblestone appearance occurs when ulcers course longitudinally through areas of normal or inflamed tissue 5657. Rectal sparing is typical and circumferential, and continuous inflammation is rare in CD 10.…”

Section: Diagnosismentioning

confidence: 99%

Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

et al. 2017

View full text Add to dashboard Cite

Crohn's disease (CD) is a chronic relapsing and remitting inflammatory disease of the gastrointestinal tract. CD is rare in Taiwan and other Asian countries, but its prevalence and incidence have been steadily increasing. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of CD taking into account currently available evidence and the expert opinion of the committee. Thorough clinical, endoscopic, and histological assessments are required for accurate diagnosis of CD. Computed tomography and magnetic resonance imaging are complementary to endoscopic evaluation for disease staging and detecting complications. The goals of CD management are to induce and maintain remission, reduce the risk of complications, and improve quality of life. Corticosteroids are the mainstay for inducing re-mission. Immunomodulating and biologic therapies should be used to maintain remission. Patients should be evaluated for hepatitis B virus and tuberculosis infection prior to treatment and receive regular surveillance for cancer. These consensus statements are based on current local evidence with consideration of factors, and could be serve as concise and practical guidelines for supporting clinicians in the management of patients with CD in Taiwan.

show abstract

Section: Diagnosismentioning

confidence: 99%

Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

et al. 2017

View full text Add to dashboard Cite

show abstract

“…CD and ITB share many similarities in clinical manifestations and signs, which make them difficult to differentiate [14] . Some studies have proposed certain criteria for identifying CD and ITB, but these criteria have been shown to have great limitations [15][16][17] . In this study, common symptoms of CD and ITB, such as abdominal pain, diarrhea and ascites, had no significant differences between two groups.…”

Section: Discussionmentioning

confidence: 99%

Application value of tissue tuberculosis antigen combined with Xpert MTB/RIF detection in differential diagnosis of intestinal tuberculosis and Crohn’s disease

Fei

Zhou

Zhang

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: The purpose of this study was to evaluate the value of Xpert MTB/RIF detection and tuberculosis antigen detection of Mycobacterium tuberculosis (MTB) in intestinal tissues for differentiating intestinal tuberculosis (ITB) from Crohn’s disease (CD). Materials and Methods: A total of 110 patients who were clinically diagnosed with CD or ITB between January 2016 and March 2018 were initially enrolled in this study. The patients were monitored and their clinical, endoscopic and histopathological characteristics were followed up until their final diagnosis was clearly made. Several specimens of intestinal tissue from endoscopic biopsy or surgical excision were collected. One piece was used as paraffin specimen, and the other two pieces were used for MTB culture and Xpert MTB/RIF detection, respectively. Four antigens (38KDa protein, ESAT-6 protein, MPT64, Ag85 complex) of MTB in intestinal tissue were detected by immunohistochemistry. Results: A total of 42 cases of intestinal tuberculosis and 46 cases of CD were included in the experimental analysis. Perianal lesions and longitudinal ulcers were more common in CD patients (p < 0.05), while caseous granuloma and annular ulcers were more common in ITB patients (P < 0.05). The positive rate of M. tuberculosis detected by Xpert MTB/RIF in intestinal tissue samples of ITB patients was 33.33%, which was significantly higher compared to CD patients (p < 0.05) and compared to acid-fast staining smears (9.52%) (p < 0.05). The positive MPT64 expression rate in patients with intestinal tuberculosis was 40.48%, which was significantly higher than that observed in CD patients, which was 19.56% (X2=4.61, p<0.05). Conclusions: The detection of Xpert MTB/RIF in intestinal tissue was conducive to the quick and early diagnosis of intestinal tuberculosis. Xpert MTB/RIF and MPT64 antigen in intestinal tissues had certain value in the differential diagnosis of intestinal tuberculosis and Crohn’s disease. The combination of these two methods could improve detection sensitivity.

show abstract

“…Discussion differentiate [18] . Some studies have proposed certain criteria for identifying CD and ITB, but these criteria have been shown to have great limitations [19][20][21] . In this study, common symptoms of CD and ITB, such as abdominal pain, diarrhea and ascites, had no significant differences between two groups.…”

Section: Detection Of Mtbc By Intestinal Tuberculosis Protein Combinementioning

confidence: 99%

Application value of tissue tuberculosis antigen combined with Xpert MTB/RIF detection in differential diagnosis of intestinal tuberculosis and Crohn’s disease

Fei

Zhou

Luo

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The purpose of this study was to evaluate the value of Xpert MTB/RIF detection and tuberculosis antigen detection of Mycobacterium tuberculosis cluster (MTBC) in intestinal tissues for differentiating intestinal tuberculosis (ITB) from Crohn’s disease (CD). Methods: A total of 110 patients who were clinically diagnosed with CD or ITB were monitored. Several specimens of intestinal tissue from endoscopic biopsy or surgical excision were used for culture and Xpert MTB/RIF for detection of MTBC, respectively. Four antigens (38KDa, ESAT-6, MPT64, Ag85 complex) of MTBC in intestinal tissue were detected by immunohistochemistry. Results: A total of 42 cases of intestinal tuberculosis and 46 cases of CD were included in the experimental analysis. Perianal lesions and longitudinal ulcers were more common in CD patients (p < 0.05), while caseous granuloma and annular ulcers were more common in ITB patients (P < 0.05). The positive rate of MTBC detected by Xpert MTB/RIF in intestinal tissue samples of ITB patients was 33.33%, which was significantly higher compared to CD patients (p < 0.05) and compared to acid-fast staining smears (9.52%) (p < 0.05). The positive MPT64 expression rate in patients with intestinal tuberculosis was 40.48%, which was significantly higher than that observed in CD patients, which was 19.56% (p<0.05). Conclusions: The detection of Xpert MTB/RIF in intestinal tissue is a rapid and useful method for establishing an early diagnosis of intestinal tuberculosis. The detection of Xpert MTB/RIF and MPT64 antigen in intestinal tissues have definitive value in the differential diagnosis of intestinal tuberculosis and Crohn’s disease. The combination of these two methods could improve detection sensitivity.

show abstract

Endoscopic Diagnosis and Differentiation of Inflammatory Bowel Disease

Cited by 49 publications

References 25 publications

Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

Application value of tissue tuberculosis antigen combined with Xpert MTB/RIF detection in differential diagnosis of intestinal tuberculosis and Crohn’s disease

Application value of tissue tuberculosis antigen combined with Xpert MTB/RIF detection in differential diagnosis of intestinal tuberculosis and Crohn’s disease

Contact Info

Product

Resources

About