Development of a Prediction Model for Differential Diagnosis Between Intestinal Tuberculosis and Crohn's Disease

Crohn's disease and intestinal tuberculosis mimic each other in clinical, endoscopic, and histological features. In addition, the yield of microbiological/histological test (AFB stain, caseating granuloma) is not high in clinical setting. Therefore, distinguishing CD from ITB especially in highly endemic areas for TB is challenging. The aim of this study is to develop and to validate a scoring system and a prediction model for differential diagnosis between intestinal tuberculosis and Crohn's disease

Final diagnostic criteria:

• Crohn' disease (at least two of the following is met)

• Clinical history of abdominal pain, weight loss, malaise, diarrhea, and/or rectal bleeding
• Endoscopic findings of mucosal cobblestoning, linear ulceration, skip areas, or perianal disease
• Radiologic findings of stricture, fistula, mucosal cobblestoning, or ulceration
• Macroscopic appearance of bowel-wall induration, mesenteric lymphadenopathy, and "creeping fat" at laparotomy
• Pathologic findings of transmural inflammation and/or epithelioid granulomas
• Intestinal tuberculosis(at least one of the following is met)

• Histologic evidence of caseating granulomas
• Histologic demonstration of acid-fast bacilli
• Growth of M. tuberculosis on tissue culture
• Clinical, colonoscopic, radiologic, and/or operative evidence of Intestinal tuberculosis with proved tuberculosis elsewhere
• Response to antituberculous therapy without subsequent recurrence in patients with clinical, colonoscopic, radiologic, and/or operative evidence of Intestinal tuberculosis

Exclusion criteria

• Refusal to participate in the study
• Age: 15 years or younger
• Comorbidity with acute infectious disease
• Pregnancy
• Previous history of medication including anti-TB drugs, immunosuppressive drugs, and chemotherapeutic agents\\
• Use of antibiotics within the previous three months