期刊文献+
共找到1,760篇文章
< 1 2 88 >
每页显示 20 50 100
Differential diagnosis of Crohn’s disease and intestinal tuberculosis based on ATR-FTIR spectroscopy combined with machine learning 被引量:1
1
作者 Yuan-Peng Li Tian-Yu Lu +5 位作者 Fu-Rong Huang Wei-Min Zhang Zhen-Qiang Chen Pei-Wen Guang Liang-Yu Deng Xin-Hao Yang 《World Journal of Gastroenterology》 SCIE CAS 2024年第10期1377-1392,共16页
BACKGROUND Crohn’s disease(CD)is often misdiagnosed as intestinal tuberculosis(ITB).However,the treatment and prognosis of these two diseases are dramatically different.Therefore,it is important to develop a method t... BACKGROUND Crohn’s disease(CD)is often misdiagnosed as intestinal tuberculosis(ITB).However,the treatment and prognosis of these two diseases are dramatically different.Therefore,it is important to develop a method to identify CD and ITB with high accuracy,specificity,and speed.AIM To develop a method to identify CD and ITB with high accuracy,specificity,and speed.METHODS A total of 72 paraffin wax-embedded tissue sections were pathologically and clinically diagnosed as CD or ITB.Paraffin wax-embedded tissue sections were attached to a metal coating and measured using attenuated total reflectance fourier transform infrared spectroscopy at mid-infrared wavelengths combined with XGBoost for differential diagnosis.RESULTS The results showed that the paraffin wax-embedded specimens of CD and ITB were significantly different in their spectral signals at 1074 cm^(-1) and 1234 cm^(-1) bands,and the differential diagnosis model based on spectral characteristics combined with machine learning showed accuracy,specificity,and sensitivity of 91.84%,92.59%,and 90.90%,respectively,for the differential diagnosis of CD and ITB.CONCLUSION Information on the mid-infrared region can reveal the different histological components of CD and ITB at the molecular level,and spectral analysis combined with machine learning to establish a diagnostic model is expected to become a new method for the differential diagnosis of CD and ITB. 展开更多
关键词 Infrared spectroscopy Machine learning intestinal tuberculosis Crohn’s disease Differential diagnosis Inflammatory bowel disease
下载PDF
Intestinal tuberculosis with small bowel stricture and hemorrhage as the predominant manifestation: Three case reports
2
作者 Gang Huang Kang-Kang Wu +2 位作者 Xiao-Na Li Jing-Hua Kuai Ai-Jun Zhang 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第1期248-256,共9页
BACKGROUND Intestinal tuberculosis is a chronic disease caused by Mycobacterium tuberculosis that mainly affects the ileum and cecum.Small bowel tuberculosis,characterized by predominant involvement of the small intes... BACKGROUND Intestinal tuberculosis is a chronic disease caused by Mycobacterium tuberculosis that mainly affects the ileum and cecum.Small bowel tuberculosis,characterized by predominant involvement of the small intestine,is an extremely rare condition with highly atypical clinical presentations,making diagnosis even more challenging.CASE SUMMARY We report three cases of small intestinal tuberculosis,two of the patients pre-sented primarily with abdominal pain,and one presented with gastrointestinal bleeding.All patients underwent blood tests and imaging examinations.Small bowel endoscopy(SBE)revealed that the main lesions in these patients were in-testinal stenosis or gastrointestinal bleeding caused by small intestinal ulcers.One patient ultimately underwent surgical treatment.Following a complex diagnostic process and comprehensive analysis,all patients were confirmed to have small intestinal tuberculosis and received standard antituberculosis treatment,leading to an improvement in their condition.CONCLUSION Patients with SBTs present with nonspecific symptoms such as abdominal pain,weight loss,and occasional gastrointestinal bleeding.Accurate diagnosis requires a thorough evaluation of clinical symptoms and various tests to avoid misdiagno-sis and complications. 展开更多
关键词 intestinal tuberculosis Gastrointestinal hemorrhage Small bowel endoscopy Case report
下载PDF
Esophageal tuberculosis complicated with intestinal tuberculosis: A case report 被引量:3
3
作者 Lei Mao Xue-Ting Zhou +5 位作者 Ji-Pin Li Jun Li Fang Wang Hui-Min Ma Xiao-Lu Su Xiang Wang 《World Journal of Clinical Cases》 SCIE 2020年第3期645-651,共7页
BACKGROUND Although the overall incidence of tuberculosis in underdeveloped areas has increased in recent years, esophageal tuberculosis(ET) is still rare. Intestinal tuberculosis(ITB) is relatively more common, but t... BACKGROUND Although the overall incidence of tuberculosis in underdeveloped areas has increased in recent years, esophageal tuberculosis(ET) is still rare. Intestinal tuberculosis(ITB) is relatively more common, but there are few reports of ET complicated with ITB. We report a case of secondary ET complicated with ITB in a previously healthy patient.CASE SUMMARY A 27-year-old female was hospitalized for progressive dysphagia, retrosternal pain, acid regurgitation, belching, heartburn, and nausea. Upper gastrointestinal endoscopy showed a mid-esophageal ulcerative hyperplastic lesion. Endoscopic ultrasonography showed a homogeneous hypoechoic lesion, with adjacent enlarged lymph nodes. Biopsy histopathology showed inflammatory exudation,exfoliated epithelial cells and interstitial granulation tissue proliferation.Colonoscopy revealed a rat-bite ulcer in the terminal ileum and a superficial ulcer in the ascending colon, near the ileocecal region. The ileum lesion biopsy showed focal granulomas with caseous necrosis. Polymerase chain reaction for Mycobacterium tuberculosis was positive in the esophageal and ileum lesion biopsies. The T-cell spot tuberculosis test was also positive. The patient was diagnosed with secondary ET infiltrated by mediastinal lymphadenopathy and complicated with ITB, possibly from the Mycobacterium tuberculosis-infected esophageal lesion. After 2 mo of anti-tuberculosis therapy, her symptoms improved significantly, and upper gastrointestinal endoscopy showed healing ulcers.CONCLUSION When dysphagia or odynophagia occurs in patients at high-risk for tuberculosis,ET should be considered. 展开更多
关键词 Esophageal tuberculosis intestinal tuberculosis DYSPHAGIA Endoscopic ultrasonography tuberculosis drug therapy Case report
下载PDF
Diagnosis of intestinal tuberculosis using a monoclonal antibody to Mycobacterium tuberculosis 被引量:12
4
作者 Yasushi Ihama Akira Hokama +9 位作者 Kenji Hibiya Kazuto Kishimoto Manabu Nakamoto Tetsuo Hirata Nagisa Kinjo Haley L Cash Futoshi Higa Masao Tateyama Fukunori Kinjo Jiro Fujita 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第47期6974-6980,共7页
AIM:To investigate the utility of immunohistochemical(IHC) staining with an antibody to Mycobacterium tuberculosis(M.tuberculosis) for the diagnosis of intestinal tuberculosis(TB).METHODS:We retrospectively identified... AIM:To investigate the utility of immunohistochemical(IHC) staining with an antibody to Mycobacterium tuberculosis(M.tuberculosis) for the diagnosis of intestinal tuberculosis(TB).METHODS:We retrospectively identified 10 patients(4 males and 6 females;mean age = 65.1 ± 13.6 years) with intestinal TB.Clinical characteristics,including age,gender,underlying disease,and symptoms were obtained.Chest radiograph and laboratory tests,including sputum Ziehl-Neelsen(ZN) staining,M.tuberculosis culture,and sputum polymerase chain reaction(PCR) for tubercle bacilli DNA,as well as Tuberculin skin test(TST) and QuantiFERON-TB gold test(QFT),were examined.Colonoscopic records recorded on the basis of Sato's classification were also reviewed,in addition to data from intestinal biopsies examined for histopathological findings,including hematoxylin and eosin staining,and ZN staining,as well as M.tuberculosis culture,and PCR for tubercle bacilli DNA.For the present study,archived formalin-fixed paraffin-embedded(FFPE) intestinal tissue samples were immunohistochemically stained using a commercially available species-specific monoclonal antibody to the 38-kDa antigen of the M.tuberculosis complex.These sections were also stained with the pan-macrophage marker CD68 antibody.RESULTS:From the clinical data,we found that no patients were immunocompromised,and that the main symptoms were diarrhea and weight loss.Three patients displayed active pulmonary TB,six patients(60%) had a positive TST,and 4 patients(40%) had a positive QFT.Colonoscopic findings revealed that all patients had type 1 findings(linear ulcers in a circumferential arrangement or linear ulcers arranged circumferentially with mucosa showing multiple nodules),all of which were located in the right hemicolon and/or terminal ileum.Seven patients(70%) had concomitant healed lesions in the ileocecal area.No acid-fast bacilli were detected with ZN staining of the intestinal tissue samples,and both M.tuberculosis culture and PCR for tubercle bacilli DNA were negative in all samples.The histopathological data revealed that tuberculous granulomas were present in 4 cases(40%).IHC staining in archived FFPE samples with anti-M.tuberculosis monoclonal antibody revealed positive findings in 4 patients(40%);the same patients in which granulomas were detected by hematoxylin and eosin staining.M.tuberculosis antigens were found to be mostly intracellular,granular in pattern,and primarily located in the CD68 + macrophages of the granulomas.CONCLUSION:IHC staining with a monoclonal antibody to M.tuberculosis may be an efficient and simple diagnostic tool in addition to classic examination methods for the diagnosis of intestinal TB. 展开更多
关键词 COLONOSCOPY intestinal tuberculosis IMMUNOHISTOCHEMISTRY Monoclonal antibody Mycobacterium tuberculosis
下载PDF
Immune thrombocytopenic purpura induced by intestinal tuberculosis in a liver transplant recipient 被引量:1
5
作者 Renata dos Santos Lugao Marina Pamponet Motta +5 位作者 Matheus Freitas Cardoso de Azevedo Roque Gabriel Rezende de Lima Flávia de Azevedo Abrantes Edson Abdala Flair José Carrilho Daniel Ferraz de Campos Mazo 《World Journal of Gastroenterology》 SCIE CAS 2014年第25期8304-8308,共5页
A variety of clinical manifestations are associated directly or indirectly with tuberculosis. Among them, haematological abnormalities can be found in both the pulmonary and extrapulmonary forms of the disease. We rep... A variety of clinical manifestations are associated directly or indirectly with tuberculosis. Among them, haematological abnormalities can be found in both the pulmonary and extrapulmonary forms of the disease. We report a case of immune thrombocytopenic purpura(ITP) associated with intestinal tuberculosis in a liver transplant recipient. The initial management of thrombocytopenia, with steroids and intravenous immunoglobulin, was not successful, and the lack oftuberculosis symptoms hampered a proper diagnostic evaluation. After the diagnosis of intestinal tuberculosis and the initiation of specific treatment, a progressive increase in the platelet count was observed. The mechanism of ITP associated with tuberculosis has not yet been well elucidated, but this condition should be considered in cases of ITP that are unresponsive to steroids and intravenous immunoglobulin, especially in immunocompromised patients and those from endemic areas. 展开更多
关键词 Immune thrombocytopenic purpura tuberculosis Liver transplant THROMBOCYTOPENIA intestinal tuberculosis
下载PDF
Differentiating Crohn's disease from intestinal tuberculosis 被引量:25
6
作者 Saurabh Kedia Prasenjit Das +5 位作者 Kumble Seetharama Madhusudhan Siddhartha Dattagupta Raju Sharma Peush Sahni Govind Makharia Vineet Ahuja 《World Journal of Gastroenterology》 SCIE CAS 2019年第4期418-432,共15页
Differentiating Crohn's disease(CD) and intestinal tuberculosis(ITB) has remained a dilemma for most of the clinicians in the developing world, which are endemic for ITB, and where the disease burden of inflammato... Differentiating Crohn's disease(CD) and intestinal tuberculosis(ITB) has remained a dilemma for most of the clinicians in the developing world, which are endemic for ITB, and where the disease burden of inflammatory bowel disease is on the rise. Although, there are certain clinical(diarrhea/hematochezia/perianal disease common in CD; fever/night sweats common in ITB), endoscopic(longitudinal/aphthous ulcers common in CD; transverse ulcers/patulous ileocaecal valve common in ITB), histologic(caseating/confluent/large granuloma common in ITB; microgranuloma common in CD), microbiologic(positive stain/culture for acid fast-bacillus in ITB), radiologic(long segment involvement/comb sign/skip lesions common in CD; necrotic lymph node/contiguous ileocaecal involvement common in ITB), and serologic differences between CD and ITB, the only exclusive features are caseation necrosis on biopsy, positive smear for acid-fast bacillus(AFB) and/or AFB culture, and necrotic lymph node on cross-sectional imaging in ITB. However,these exclusive features are limited by poor sensitivity, and this has led to the development of multiple multi-parametric predictive models. These models are also limited by complex formulae, small sample size and lack of validation across other populations. Several new parameters have come up including the latest Bayesian meta-analysis, enumeration of peripheral blood T-regulatory cells, and updated computed tomography based predictive score. However, therapeutic anti-tubercular therapy(ATT) trial, and subsequent clinical and endoscopic response to ATT is still required in a significant proportion of patients to establish the diagnosis. Therapeutic ATT trial is associated with a delay in the diagnosis of CD, and there is a need for better modalities for improved differentiation and reduction in the need for ATT trial. 展开更多
关键词 Crohn's disease intestinal tuberculosis Endoscopy COMPUTED tomographic ENTEROGRAPHY GRANULOMA
下载PDF
Histopathology and TB-PCR kit analysis in differentiating the diagnosis of intestinal tuberculosis and Crohn’s disease 被引量:20
7
作者 Joon Mee Kim Hyung Kil Kim +6 位作者 Lucia Kim Suk Jin Choi In Suh Park Jee Young Han Young Chae Chu Kye Sook Kwon Eun Joo Kim 《World Journal of Gastroenterology》 SCIE CAS CSCD 2010年第20期2496-2503,共8页
AIM: To compare the histopathologic features of intestinal tuberculosis (ITB) and Crohn’s disease (CD) and to identify whether polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR) would be helpful for di... AIM: To compare the histopathologic features of intestinal tuberculosis (ITB) and Crohn’s disease (CD) and to identify whether polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR) would be helpful for differential diagnosis between ITB and CD.METHODS: We selected 97 patients with established diagnoses (55 cases of ITB and 42 cases of CD) who underwent colonoscopic biopsies.Microscopic features of ITB and CD were reviewed,and eight pathologic parameters were evaluated.Nine cases of acid fast bacilli culture-positive specimens and 10 normal colonic tissue specimens were evaluated as the positive and negative control of the TB-PCR test,respectively.PCR assays were done using two commercial kits: kit <A> detected IS6110 and MPB64,and kit <B> detected IS6110 only;a manual in-house PCR method was also performed on formalin-fi xed,paraffi n-embedded colonoscopic biopsy specimens.RESULTS: Statistically significant differences were noted between ITB and CD with regard histopathologic criteria: size of granulomas (P = 0.000),giant cells (P = 0.015),caseation necrosis (P = 0.003),confluent granulomas (P = 0.001),discrete granulomas (P = 0.000),and granulomas with lymphoid cuffs (P = 0.037).However,29 cases (52.7%) of ITB showed less than fi ve kinds of pathologic parameters,resulting in confusion with CD.The sensitivities and specificities of the TB-PCR test by kit <A>,kit <B>,and the in-house PCR method were 88.9% and 100%,88.9% and 100%,and 66.7% and 100% in positive and negative controls,respectively.The PCR test done on endoscopic biopsy specimens of ITB and CD were signifi cantly different with kit <A> (P = 0.000) and kit <B> (P = 0.000).The sensitivities and specifi cities of TB-PCR were 45.5% and 88.1%,36.4% and 100%,and 5.8% and 100%,for kit <A> and kit <B> and inhouse PCR method on endoscopic biopsy specimens.Among the 29 cases of histopathologically confusing CD,10 cases assayed using kit <A> and 6 cases assayed using kit <B> were TB-PCR positive.A combination of histologic fi ndings and TB-PCR testing led to an increase of diagnostic sensitivity and the increase (from 47.3% to 58.2) was statistically signifi cant with kit <B> (P = 0.000).CONCLUSION: The TB-PCR test combined with histopathologic factors appears to be a helpful technique in formulating the differential diagnosis of ITB and CD in endoscopic biopsy samples. 展开更多
关键词 intestine tuberculosis Crohn’s disease HISTOPATHOLOGY Polymerase chain reaction KIT IS6110 MPB64
下载PDF
Effectiveness of interferon-gamma release assays for differentiating intestinal tuberculosis from Crohn's disease:A meta-analysis 被引量:14
8
作者 Wen Chen Jun-Hua Fan +2 位作者 Wei Luo Peng Peng Si-Biao Su 《World Journal of Gastroenterology》 SCIE CAS 2013年第44期8133-8140,共8页
AIM:To investigate the clinical usefulness of interferon-gamma release assays(IGRAs)in the differential diagnosis of intestinal tuberculosis(ITB)from Crohn’s disease(CD)by meta-analysis.METHODS:A systematic search of... AIM:To investigate the clinical usefulness of interferon-gamma release assays(IGRAs)in the differential diagnosis of intestinal tuberculosis(ITB)from Crohn’s disease(CD)by meta-analysis.METHODS:A systematic search of English language studies was performed.We searched the following databases:Medline,Embase,Web of Science and the Cochrane Library.The Standards for Reporting Diagnostic Accuracy initiative and Quality Assessment for Studies of Diagnostic Accuracy tool were used to assess the methodological quality of the studies.Sensitivity,specificity,and other measures of the accuracy of IGRAs in the differential diagnosis of ITB from CD were pooled and analyzed using random-effects models.Receiver operating characteristic curves were applied to summarize overall test performance.Two reviewers independently judged study eligibility while screening the citations.RESULTS:Five studies met the inclusion criteria.The average inter-rater agreement between the two reviewers for items in the quality checklist was 0.95.Analysis of IGRAs for the differential diagnosis of ITB from CD produced summary estimates as follows:sensitivity,0.74(95%CI:0.68-0.80);specificity,0.87(95%CI:0.82-0.90);positive likelihood ratio,5.98(95%CI:3.79-9.43);negative likelihood ratio,0.28(95%CI:0.18-0.43);and diagnostic odds ratio,26.21(95%CI:14.15-48.57).The area under the curve was 0.92.The evaluation of publication bias was not significant(P=0.235).CONCLUSION:Although IGRAs are not sensitive enough,they provide good specificity for the accurate diagnosis of ITB,which may be helpful in the differential diagnosis of ITB from CD. 展开更多
关键词 intestinal tuberculosis Crohn’s disease INTERFERON-GAMMA META-ANALYSIS
下载PDF
Differences in clinical features of Crohn's disease and intestinal tuberculosis 被引量:8
9
作者 Xin Huang Wang-Di Liao +5 位作者 Chen Yu Yi Tu Xiao-Lin Pan You-Xiang Chen Nong-Hua Lv Xuan Zhu 《World Journal of Gastroenterology》 SCIE CAS 2015年第12期3650-3656,共7页
AIM: To investigate the clinical features of Crohn's disease(CD) and intestinal tuberculosis(ITB) with a scoring system that we have developed.METHODS: A total of 25 CD and 40 ITB patients were prospectively enrol... AIM: To investigate the clinical features of Crohn's disease(CD) and intestinal tuberculosis(ITB) with a scoring system that we have developed.METHODS: A total of 25 CD and 40 ITB patients were prospectively enrolled from August 2011 to July 2012.Their characteristics and clinical features were recorded. Laboratory, endoscopic, histologic and radiographic features were determined. The features with a high specificity were selected to establish a scoring system. The features supporting CD scored +1, and those supporting ITB scored-1; each patient received a final total score. A receiver operating characteristic(ROC) curve was used to determine the best cut-off value for distinguishing CD from ITB.RESULTS: Based on a high specificity of differentiating between CD and ITB, 12 features, including longitudinal ulcers, nodular hyperplasia, cobblestone-like mucosa, intestinal diseases, intestinal fistula, the target sign, the comb sign, night sweats, the purified protein derivative test, the interferon-γ release assay(T-SPOT.TB), ring ulcers and ulcer scars, were selected for the scoring system. The results showed that the average total score of the CD group was 3.12 ± 1.740, the average total score of the ITB group was-2.58 ± 0.984, the best cutoff value for the ROC curve was-0.5, and the diagnostic area under the curve was 0.997, which was statistically significant(P < 0.001). The patients whose total scores were higher than-0.5 were diagnosed with CD; otherwise, patients were diagnosed with ITB. Overall, the diagnostic accuracy rate and misdiagnosis rate of this scoring system were 97% and 3%, respectively. CONCLUSION: Some clinical features are valuable for CD and ITB diagnosis. The described scoring system is key to differentiating between CD and ITB. 展开更多
关键词 Crohn’s DISEASE intestinal tuberculosis CLINICAL F
下载PDF
Comparative study of intestinal tuberculosis and primary small intestinal lymphoma 被引量:5
10
作者 Qing-Qiang Zhu Wen-Rong Zhu +2 位作者 Jing-Tao Wu Wen-Xin Chen Shou-An Wang 《World Journal of Gastroenterology》 SCIE CAS 2014年第15期4446-4452,共7页
AIM: To characterize the clinical, radiological, endoscopic and pathological features of intestinal tuberculosis (ITB) and primary small intestinal lymphoma (PSIL).
关键词 intestinal tuberculosis Primary small intestinal lymphoma Clinical features Endoscopic features Computed tomography
下载PDF
Interleukin-22 receptor 1 is expressed in multinucleated giant cells:A study on intestinal tuberculosis and Crohn’s disease 被引量:5
11
作者 Zi-Qi Yu Wen-Fei Wang +2 位作者 You-Chao Dai Xin-Chun Chen Jian-Yong Chen 《World Journal of Gastroenterology》 SCIE CAS 2019年第20期2473-2488,共16页
BACKGROUND It is challenging to distinguish intestinal tuberculosis from Crohn’s disease due to dynamic changes in epidemiology and similar clinical characteristics. Recent studies have shown that polymorphisms in ge... BACKGROUND It is challenging to distinguish intestinal tuberculosis from Crohn’s disease due to dynamic changes in epidemiology and similar clinical characteristics. Recent studies have shown that polymorphisms in genes involved in the interleukin (IL)- 23/IL-17 axis may affect intestinal mucosal immunity by affecting the differentiation of Th17 cells. AIM To investigate the specific single-nucleotide polymorphisms (SNPs) in genes involved in the IL-23/IL-17 axis and possible pathways that affect susceptibility to intestinal tuberculosis and Crohn's disease. METHODS We analysed 133 patients with intestinal tuberculosis, 128 with Crohn’s disease, and 500 normal controls. DNA was extracted from paraffin-embedded specimens or whole blood. Four SNPs in the IL23/Th17 axis (IL22 rs2227473, IL1β rs1143627, TGFβ rs4803455, and IL17 rs8193036) were genotyped with TaqMan assays. The transcriptional activity levels of different genotypes of rs2227473 were detected by dual luciferase reporter gene assay. The expression of IL-22R1 in different intestinal diseases was detected by immunohistochemistry. RESULTS The A allele frequency of rs2227473 (P = 0.030, odds ratio = 0.60, 95% confidence interval: 0.37-0.95) showed an abnormal distribution between intestinal tuberculosis and healthy controls. The presence of the A allele was associated with a higher IL-22 transcriptional activity (P < 0.05). In addition, IL-22R1 was expressed in intestinal lymphoid tissues, especially under conditions of intestinal tuberculosis, and highly expressed in macrophage-derived Langhans giant cells. The results of immunohistochemistry showed that the expression of IL-22R1 in patients with Crohn's disease and intestinal tuberculosis was significantly higher than that in patients with intestinal polyps and colon cancer (P < 0.01). CONCLUSION High IL-22 expression seems to be a protective factor for intestinal tuberculosis. IL-22R1 is expressed in Langhans giant cells, suggesting that the IL-22/IL-22R1 system links adaptive and innate immunity. 展开更多
关键词 Crohn's disease intestinal tuberculosis Single-nucleotide polymorphism INTERLEUKIN-22 INTERLEUKIN-22 RECEPTOR 1 Multinucleated giant cells
下载PDF
Temporal trends in the misdiagnosis rates between Crohn's disease and intestinal tuberculosis 被引量:5
12
作者 Hyungil Seo Seohyun Lee +13 位作者 Hoonsub So Donghoi Kim Seon-Ok Kim Jae Seung Soh Jung Ho Bae Sun-Ho Lee Sung Wook Hwang Sang Hyoung Park Dong-Hoon Yang Kyung-Jo Kim Jeong-Sik Byeon Seung-Jae Myung Suk-Kyun Yang Byong Duk Ye 《World Journal of Gastroenterology》 SCIE CAS 2017年第34期6306-6314,共9页
AIM To investigate the temporal trends in the misdiagnosis rate between Crohn's disease(CD) and intestinal tuberculosis(ITB) in South Korea. METHODS We retrospectively reviewed the medical records of patients mana... AIM To investigate the temporal trends in the misdiagnosis rate between Crohn's disease(CD) and intestinal tuberculosis(ITB) in South Korea. METHODS We retrospectively reviewed the medical records of patients managed for CD or ITB at Asan Medical Center, a tertiary referral hospital, Seoul, Korea between 1996 and 2014. The temporal trends in the misdiagnosis rates between the two diseases were analyzed. The demographic and clinical characteristics were compared between CD patients who were initially misdiagnosed as ITB(final CD group) and vice versa(final ITB group). Final diagnostic criteria for ITB and medication for CD before definite diagnosis of TB were also analyzed in final ITB group.RESULTS In total, 2760 patients were managed for CD and 772 patients for ITB between 1996 and 2014. As well, 494 of the 2760 CD patients(17.9%) were initially misdiagnosed as ITB and 83 of the 772 ITB patients(10.8%) as CD. The temporal trend in misdiagnosing CD as ITB showed a decrease(OR = 0.89, 95%CI: 0.87-0.91, P < 0.001), whereas the temporal trend in misdiagnosing ITB as CD showed an increase(OR = 1.06, 95%CI: 1.01-1.11, P = 0.013). Age at diagnosis, presenting symptoms, and proportion of patients with active/past perianal fistula and active/inactive pulmonary tuberculosis(TB) were significantly different between final CD group and final ITB group. Forty patients(48.2%) in final ITB group were diagnosed by favorable response to empirical anti-TB treatment. Seventeen patients(20.5%) in final ITB group had inappropriately received corticosteroids and/or thiopurines due to misdiagnosis as CD. However, there were no mortalities in both groups. CONCLUSION Cases of CD misdiagnosed as ITB have been decreasing, whereas cases of ITB misdiagnosed as CD have been increasing over the past two decades. 展开更多
关键词 Crohn’s disease intestinal tuberculosis Misdiagnosis
下载PDF
Differentiation of Crohn’s disease from intestinal tuberculosis in India in 2010 被引量:8
13
作者 Anna Benjamin Pulimood Deepak Narayan Amarapurkar +5 位作者 Ujjala Ghoshal Mathew Phillip Cannanore Ganesh Pai Duvvur Nageshwar Reddy Birender Nagi Balakrishna Siddhartha Ramakrishna 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第4期433-443,共11页
Differentiating intestinal tuberculosis from Crohn’s disease (CD) is an important clinical challenge of considerable therapeutic significance. The problem is of greatest magnitude in countries where tuberculosis cont... Differentiating intestinal tuberculosis from Crohn’s disease (CD) is an important clinical challenge of considerable therapeutic significance. The problem is of greatest magnitude in countries where tuberculosis continues to be highly prevalent, and where the incidence of CD is increasing. The final clinical diagnosis is based on a combination of the clinical history with endoscopic studies, culture and polymerase chain reaction for Mycobacterium tuberculosis, biopsy pathology, radiological investigations and response to therapy. In a subset of patients, surgery is required and intraoperative findings with pathological study of the resected bowel provide a definitive diagnosis. Awareness of the parameters useful in distinguishing these two disorders in each of the different diagnostic modalities is crucial to accurate decision making. Newer techniques, such as capsule endoscopy, small bowel enteroscopy and immunological assays for Mycobacterium tuberculosis, have a role to play in the differentiation of intestinal tuberculosis and CD. This review presents currently available evidence regarding the usefulness and limitations of all these different modalities available for the evaluation of these two disorders. 展开更多
关键词 tuberculosis Crohn’s disease Clinical features ENDOSCOPY SEROLOGY ENTEROSCOPY HISTOLOGY RADIOLOGY surgery Therapy
下载PDF
Clinico-Demographic Characteristics of Intestinal Tuberculosis in Pre-Operative Unsuspected Laparotomy as Incidental Findings in Bangladesh
14
作者 Md. Mizanur Rahman Ayub Ali +3 位作者 Md. Abdullah Yusuf Md. Zamil Zaidur Rahim Md. Mahfuzur Rahman Zahir-ul Islam 《Journal of Tuberculosis Research》 2017年第2期139-145,共7页
Background: Clinical presentation of intestinal tuberculosis is varied. It is also essential to know the clinical and demographic characteristics of incidentally detected intestinal tuberculosis patient. Objective: Th... Background: Clinical presentation of intestinal tuberculosis is varied. It is also essential to know the clinical and demographic characteristics of incidentally detected intestinal tuberculosis patient. Objective: The purpose of the present study was to find out the clinic-demographic characteristics of intestinal tuberculosis in clinically and preoperatively unsuspected laparotomies. Methodology: This cross-sectional study was carried out in the Department of Surgery at Dhaka Medical College Hospital, Dhaka from March 2002 to March 2004 for a period of two (2) years. All the patients underwent laparotomy presented without any suspicion of pulmonary or intestinal tuberculosis were included as study population. Patients who were without the history of cough, haemoptysis, antitubercular drug therapy were included. Per operative suspicion was raised due to enlarged lymph nodes in mesentery, omental masses, ileocaecal masses, suspicious growth in ileum, omental thickening, perforation suspected by tuberculosis. Biopsy was taken from suspicious lesions. Histopathology was confirmed the tubercular lesion. Results: A total number of 300 patients under laparotomy were recruited for this study of which 38 positive cases were found in the study with a percentage of 12.7%. Maximum affected age group was 21 to 30 years which was 16 (42%) cases. Male was predominant to female which was 28 (73.7%) cases and 10 (26.3%) cases respectively. Low socioeconomic people are affected more (76.3%). Most common presentation in positive cases was acute and sub-acute intestinal obstruction 20 (52.6%) followed by intestinal perforation (26.31%). Conclusion: In conclusion young age male patient is the most commonly affected intestinal tuberculosis which is frequently presented with sub-acute intestinal obstruction among the preoperatively unsuspected laparotomy patients. 展开更多
关键词 intestinal tuberculosis Unsuspected LAPAROTOMY Clinic-Demographic Characteristics
下载PDF
Insights on Blood Cytokines Production under Different <i>In Vitro</i>Mycobacterial Antigens in Tuberculosis Intestinal Parasites Co Infected Patients
15
作者 Renan Jeremias da Silva Fernanda C. Q. Mello +5 位作者 Janaína A. Leung Antonio Henrique Almeida de Moraes Neto Leila de Souza Fonseca Helio Ribeiro de Siqueira Health Care Victor Vala and CSEGSF Team Maria Helena Féres Saad 《Advances in Microbiology》 2018年第3期161-174,共14页
Background: The concomitant presence of intestinal parasite infections (IP) and tuberculosis (TB) has relevance. M. tuberculosis immune response is associated with type 1 T helper cell (Th1) while IP is associated wit... Background: The concomitant presence of intestinal parasite infections (IP) and tuberculosis (TB) has relevance. M. tuberculosis immune response is associated with type 1 T helper cell (Th1) while IP is associated with type Th2 cell. However, there are several contradictory reports on cytokine production under coinfection and this could be in association to the mycobacterial antigens used in the studies. Aim: To get insight into the effects of different M. tuberculosis-specific antigens (ESAT-6/CFP-10 and 38 kDa/CFP-10) in generating of appropriate cytokines on peripheral blood mononuclear cells of IPTB co infected patients. Method: ELISA assessed IFN-γ and other 16 cytokines production and plasm IgE. In 18 months, we documented demographic, economic, clinical characteristics and IP frequency in individuals from Brazil. Results: An overall 10/35 (28.5%) were IPTB co infected and 40/76 (52.6%;p = 0.024) asymptomatic intestinal parasite infected community controls (IPCC). Endo-limax nana (40%) and Entamoeba coli (22%), were the most nonpathogenic protozoan identified and Entamoeba histolytica, Giardia intestinalis, Ascaris lumbricoides and Strongyloides stercoralis were the pathogenic species (40%). IgE was higher in IPCC (p = 0.036). Cytokine profiles were significantly biased toward a Th2 type IL-5 (p = 0.001) and IL-13 (p = 0.033), pro-inflammatory GM-CSF (p = 0.019) and borderline lower IL-1β in IPTB, all associated with ESAT-6/CFP-10, while IL-7 was borderline lower, but 38 kDa/CFP-10 associated;as well as IL-8 higher (p < 0.049) vs CC/IPCC. The TB/IPTB IFN-γ levels were similar to both antigens stimuli (p ≥ 0.208). Conclusion: Therefore, coin-cident IPTB coinfection did not exert a significant inhibitory effect in IFN-γ production in response to either of the two antigens, but the partial discrepancy in Th1/Th2 response, is associated with the antigen priming cells. 展开更多
关键词 MYCOBACTERIUM tuberculosis intestinal Parasites MYCOBACTERIAL Antigens IgE CYTOKINES
下载PDF
Abdominal tuberculosis: Is there a role for surgery? 被引量:3
16
作者 Elroy Patrick Weledji Benjamin Thumamo Pokam 《World Journal of Gastrointestinal Surgery》 SCIE CAS 2017年第8期174-181,共8页
It is important that surgeons are familiar with the various manifestations of tuberculosis(TB). Although TB has been declining in incidence in the developed world, itremains an important problem in endemic areas of th... It is important that surgeons are familiar with the various manifestations of tuberculosis(TB). Although TB has been declining in incidence in the developed world, itremains an important problem in endemic areas of the developing world. The aim of the review was to elucidate the natural history and characteristics of abdominal TB and ascertain the indications for surgery. TB can affect the intestine as well as the peritoneum and the most important aspect of abdominal TB is to bear in mind the diagnosis and obtain histological evidence. Abdominal TB is generally responsive to medical treatment, and early diagnosis and management can prevent unnecessary surgical intervention. Due to the challenges of early diagnosis, patients should be managed in collaboration with a physician familiar with anti-tuberculous therapy. An international expert consensus should determine an algorithm for the diagnosis and multidisciplinary management of abdominal TB. 展开更多
关键词 tuberculosis PERITONEAL intestinal surgery Anti-tuberculous therapy
下载PDF
Efficacy of thalidomide therapy in pediatric Crohn's disease with evidence of tuberculosis 被引量:3
17
作者 Lin Wang Yan Hong +2 位作者 Jie Wu Ying-Kit Leung Ying Huang 《World Journal of Gastroenterology》 SCIE CAS 2017年第43期7727-7734,共8页
AIM To evaluate the efficacy of thalidomide for treating troublesome cases of pediatric Crohn's disease(CD) with tuberculosis infection.METHODS A retrospective study of clinical outcome among children treated with... AIM To evaluate the efficacy of thalidomide for treating troublesome cases of pediatric Crohn's disease(CD) with tuberculosis infection.METHODS A retrospective study of clinical outcome among children treated with thalidomide was conducted. All patients had evidence of tuberculosis infection with a failure of anti-tuberculosis treatment for more than one year,and were subsequently diagnosed with CD. All the patients received thalidomide treatment with a starting dose of 1.2-2.5 mg/kg per day. Remission was defined as pediatric CD activity index less than or equal to 10.RESULTS Ten patients with CD were treated with thalidomide at an average age of 7.2 years and followed up for a median of 22.2 mo. Clinical remission rate was 60% after 9-12 mo of thalidomide treatment. One patient with no response had an interleukin-10 receptor alpha gene mutation. Erythrocyte sedimentation rate,C-reactive protein and platelet count showed a dramatic decrease; hemoglobin level and weight improved significantly after thalidomide treatment when compared with the baseline values.CONCLUSION Thalidomide is an effective and safe drug for remission of CD in pediatric patients who have been treated for tuberculosis. 展开更多
关键词 Inflammatory bowel disease intestinal tuberculosis Anti-tubercular treatment THALIDOMIDE CHILDREN
下载PDF
Liver Transplantation in a Monolung Patient: A Strategy of Sequential Treatments of Multiple Lung Tuberculosis Ca-vitations and Hepatocellular Carcinoma on Hepatitis B Related Virus Cirrhosis 被引量:1
18
作者 Dino Donataccio Paola Del Bravo +3 位作者 Alberto Masotto Marcello Ceola Francesco Calabrò Matteo Donataccio 《Surgical Science》 2011年第5期257-261,共5页
The presence of extrahepatic infection is a contraindication for liver transplantation, even more if supported by an advanced pulmonary tuberculosis with persistent cavitation not curable with medical treatment. We re... The presence of extrahepatic infection is a contraindication for liver transplantation, even more if supported by an advanced pulmonary tuberculosis with persistent cavitation not curable with medical treatment. We report a case of a young patient with hepatocellular carcinoma on hepatitis B virus related liver cirrhosis and multiple lung tuberculosis cavitations. The patient was referred to our centre for liver transplantation. We adopted a strategy with sequential treatments. First a left extra-pericardial pneumonectomy was performed without opening the infected cavern, followed by a therapy with rifampicin, isoniazid and ethambutol for a period of nine months. After the cure of tuberculosis, the monolung patient eventually was listed for liver transplantation. An accurate planning of a multistep therapeutical strategy, an appropriate anesthetic management and a meticulous surgical technique allowed to successfully transplant a young patient suffering from three life-threatening diseases: cavitary tuberculosis, hepatitis B virus cirrhosis and hepatocellular carcinoma. Thirty months after liver transplantation the patient is in good health, with normal liver function, forced expiratory volume in one second of 42% (1.53 liters) and without any tuberculosis disease reactivation. 展开更多
关键词 MYCOBACTERIUM tuberculosis Infection PNEUMONECTOMY LIVER Disease LIVER surgery
下载PDF
Diagnostic approaches for pancreatic tuberculosis
19
作者 Chang-Xin Wu Li-Bing Xiao +1 位作者 Zhong-Fei Luo Shao-Hua Shi 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2023年第1期107-110,共4页
To the Editor:Pancreatic tuberculosis refers to tuberculosis of pancreas and peripancreatic lymph nodes due to both conditions having similar clinical manifestations and therapeutic regimens[1,2].It is a rare entity w... To the Editor:Pancreatic tuberculosis refers to tuberculosis of pancreas and peripancreatic lymph nodes due to both conditions having similar clinical manifestations and therapeutic regimens[1,2].It is a rare entity worldwide,which is often shown as mass and treated by the unnecessary surgery due to misdiagnosis as pancreatic malignancy[1,2]. 展开更多
关键词 tuberculosis CLINICAL surgery
下载PDF
Successful surgical treatment of bronchopleural fistula caused by severe pulmonary tuberculosis:A case report and review of literature
20
作者 Lei Shen Yu-Hui Jiang Xi-Yong Dai 《World Journal of Clinical Cases》 SCIE 2023年第10期2282-2289,共8页
BACKGROUND Bronchopleural fistula(BPF)is a relatively rare,but severe complication of pulmonary tuberculosis.It is associated with significant mortality;however,its management remains a major therapeutic challenge.CAS... BACKGROUND Bronchopleural fistula(BPF)is a relatively rare,but severe complication of pulmonary tuberculosis.It is associated with significant mortality;however,its management remains a major therapeutic challenge.CASE SUMMARY We present a 24-year-old man with BPF resulting from severe pulmonary tuberculosis combined with mixed infections.The damaged right upper lobe and concomitant empyema were demonstrated via computed tomography.After undergoing open-window thoracostomy and tuberculosis treatment for 4 mo,decortication and right upper lobectomy were subsequently performed,leading to the resolution of tuberculosis and other concurrent pulmonary infections.Followup,6 mo after surgery,failed to reveal any evidence of infection recurrence resulting in a good prognosis.CONCLUSION The disease course of tuberculous BPF is particularly challenging.Surgical intervention serves as an effective and safe therapeutic strategy for BPF. 展开更多
关键词 Bronchopleural fistula tuberculosis surgery Case report
下载PDF
上一页 1 2 88 下一页 到第
使用帮助 返回顶部