Faecal calprotectin levels differentiate intestinal from pulmonary tuberculosis: An observational study from Southern India

Larsson, Geir; Shenoy, K T; Ramasubramanian, Ramalingom; Thayumanavan, L; Balakumaran, Leena K.; Bjune, Gunnar; Moum, Bjørn

doi:10.1177/2050640614546947

Cited by 10 publications

(6 citation statements)

References 32 publications

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“…The advantage of QFT-G-IT is that it avoids a cross-reaction with the bacillus Calmette-Guérin vaccination and most non-tuberculous mycobacteria; however, malnutrition and helminth co-infection may decrease its sensitivity. 44 Moreover, the sensitivity and specificity of T-SPOT.TB are reported to be 84.2-86% and 75.4-93%, respectively; the negative predictive value is as high as 91-94.2%. 45,46 Therefore, it is reasonable to rule out ITB when the T-SPOT.TB is negative in confusing cases.…”

Section: Laboratory Examinationsmentioning

confidence: 98%

“…A systematic review conducted by Ng et al reported a sensitivity of 81% and a specificity of 85% of IGRA in the diagnosis of ITB. The advantage of QFT‐G‐IT is that it avoids a cross‐reaction with the bacillus Calmette‐Guérin vaccination and most non‐tuberculous mycobacteria; however, malnutrition and helminth co‐infection may decrease its sensitivity . Moreover, the sensitivity and specificity of T‐SPOT.TB are reported to be 84.2–86% and 75.4–93%, respectively; the negative predictive value is as high as 91–94.2% .…”

Section: Laboratory Examinationsmentioning

confidence: 99%

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Intestinal tuberculosis and Crohn's disease: challenging differential diagnosis

Jia¹,

Jin²,

Ran

2016

J of Digest Diseases

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Along with epidemiological changes in tuberculosis (TB) and an increased incidence of Crohn's disease (CD), the differential diagnosis of intestinal TB (ITB) and CD is of vital importance and has become a clinical challenge because treatment based on misdiagnosis may lead to fatal outcomes. In this study, we reviewed the similarities and differences in clinical, endoscopic, radiological and histological features of these two diseases. Concomitant pulmonary TB, ascites, night sweats, involvement of fewer than four segments of the bowel, patulous ileocecal valve, transverse ulcers, scars or pseudopolyps strongly indicate ITB. Bloody stools, perianal signs, chronic diarrhea, extraintestinal manifestations, anorectal lesions, longitudinal ulcers and a cobblestone appearance are all suggestive of CD. Significant differences in the size, number, location and patterns of granulomas in ITB and CD with regard to their histopathologic features have been noted. Immune stain of cell surface markers is also helpful. Interferon-γ release assay and polymerase chain reaction analysis have achieved satisfactory sensitivity and specificity in the diagnosis of ITB. Computed tomography enterographic findings of segmental small bowel or left colon involvement, mural stratification, the comb sign and fibrofatty proliferation are significantly more common in CD, whereas mesenteric lymph node changes (calcification or central necrosis) and focal ileocecal lesions are more frequently seen in ITB. A diagnosis should be carefully established before the initiation of the therapy. In suspicious cases, short-term empirical anti-TB therapy is quite efficient to further confirm the diagnosis.

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Section: Laboratory Examinationsmentioning

confidence: 98%

Section: Laboratory Examinationsmentioning

confidence: 99%

Intestinal tuberculosis and Crohn's disease: challenging differential diagnosis

Jia¹,

Jin²,

Ran

2016

J of Digest Diseases

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“…High fecal CLP levels in intestinal tuberculosis were associated with granulomas in intestinal biopsies [ 79 ]. Patients with combined pulmonary and intestinal tuberculosis had the highest serum CLP (6.5 mg/L) and presented more severe disease [ 80 ]. The functional impairment of interaction between Zn finger genes and interferon-stimulated genes, along with a higher expression of S100A8/A9 genes, possibly form the genomic basis of tuberculosis-associated immune reconstitution inflammatory syndrome (IRIS) in a subset of patients with human immunodeficiency virus (HIV) while on highly active antiretroviral therapy [ 80 , 81 ].…”

Section: Clp In Respiratory Infectionsmentioning

confidence: 99%

Calprotectin in Lung Diseases

Kotsiou

Papagiannis

Papadopoulou

et al. 2021

IJMS

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Calprotectin (CLP) is a heterodimer formed by two S-100 calcium-binding cytosolic proteins, S100A8 and S100A9. It is a multifunctional protein expressed mainly by neutrophils and released extracellularly by activated or damaged cells mediating a broad range of physiological and pathological responses. It has been more than 20 years since the implication of S100A8/A9 in the inflammatory process was shown; however, the evaluation of its role in the pathogenesis of respiratory diseases or its usefulness as a biomarker for the appropriate diagnosis and prognosis of lung diseases have only gained attention in recent years. This review aimed to provide current knowledge regarding the potential role of CLP in the pathophysiology of lung diseases and describe how this knowledge is, up until now, translated into daily clinical practice. CLP is involved in numerous cellular processes in lung health and disease. In addition to its anti-microbial functions, CLP also serves as a molecule with pro- and anti-tumor properties related to cell survival and growth, angiogenesis, DNA damage response, and the remodeling of the extracellular matrix. The findings of this review potentially introduce CLP in daily clinical practice within the spectrum of respiratory diseases.

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“…29 Dalam literatur lain, Larsson, dkk. 30 juga mengemukakan matrix model sebagai prediktor untuk membedakan TB intestinal dengan penyakit Crohn. Empat variabel yang terkait secara bermakna sebagai prediktor TB intestinal adalah penurunan berat badan, nodularitas mukosa, calprotectin feses ≥200μg/g, sedangkan prediktor penyakit Crohn adalah keterlibatan multisegmen dan calprotectin feses ≤200 μg/g.…”

Section: Laboratorium Penunjangunclassified

“…Jika model prediktor ini digabungkan dengan endoskopi dapat digunakan untuk membedakan TB intestinal dan penyakit Crohn. 30 Beberapa tahun terakhir, interferon gamma release assay (IGRA) digunakan untuk membedakan TB intestinal dengan penyakit Crohn. Terdapat 2 metode pemeriksaan IGRA, yaitu Quantiferon-TB Gold (QFT-G) dan T-SPOT-TB.…”

Section: Laboratorium Penunjangunclassified

Pendekatan Diagnosis dan Tatalaksana Tuberkulosis Intestinal

Murwaningrum¹,

Abdullah²,

Makmun³

2017

JPDI

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ABSTRAKTuberkulosis (TB) telah menjadi masalah global yang terus membesar seiring dengan bertambahnya jumlah pasien TB. Infeksi TB masih merupakan hal yang umum ditemukan dan merupakan faktor penting terhadap angka kesakitan dan kematian, terutama pada negara yang belum dan sedang berkembang. Kasus Tuberkulosis usus (TB usus) juga meningkat seiring dengan meningkatnya jumlah kasus TB secara umum. Indonesia merupakan Negara ke-2 dengan prevalensi Tuberkulosis TB tertinggi di Asia Tenggara setelah Timor Leste pada tahun 2014. TB usus adalah manifestasi TB ekstrapulmonal terbanyak keenam.Manifestasi klinis yang tidak spesifik dan kadang menyerupai beberapa kondisi lain termasuk keganasan menyebabkan diagnosis TB usus sulit ditegakkan secara akurat. Temuan dari hasil endoskopi dan gambaran radiologi dari berbagai stage penyakit sudah sangat banyak, namun diagnosis tetap sulit dilakukan. Sampai saat ini belum ada metode tunggal yang dapat mendeteksi TB usus secara tepat dan akurat, berbagai metode investigasi telah digunakan dalam diagnosis TB usus. Diagnosis yang dilakukan sejak awal, pemberian terapi anti tuberculosis dan tindakan bedah adalah hal-hal esensial dalam pencegahan terjadinya kesakitan dan kematian akibat TB usus, sehingga dibutuhkan kombinasi penilaian klinis dan pemeriksaan berbagai modalitas. Pasien yang telah didiagnosis TB usus diberikan terapi obat anti tuberculosis (OAT) dan pertimbangan tindakan bedah jika mengalami komplikasi. Kata Kunci: diagnosis, tuberkulosis intestinal ABSTRACT Tuberculosis (TB) has become a resurgent global problem with increasing numbers of patients. TB infection is still common and remains an important cause of morbidity and mortality, particularly in underdeveloped and developing nations. Intestinal tuberculosis (intestinal TB) rates are rising, consistet with the overall trend. In 2014 Indonesia has the second highest TB prevalence in South East

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Faecal calprotectin levels differentiate intestinal from pulmonary tuberculosis: An observational study from Southern India

Abstract: Calprotectin analysis reveals intestinal tuberculosis in patients with pulmonary tuberculosis and pinpoints those in need of rigorous follow-up.

Cited by 10 publications

References 32 publications

Intestinal tuberculosis and Crohn's disease: challenging differential diagnosis

Intestinal tuberculosis and Crohn's disease: challenging differential diagnosis

Calprotectin in Lung Diseases

Pendekatan Diagnosis dan Tatalaksana Tuberkulosis Intestinal

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