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2016 ; 129
(11
): 1330-3
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Clinical and Laboratory Diagnosis of Intestinal Tuberculosis
#MMPMID27231171
Shi XC
; Zhang LF
; Zhang YQ
; Liu XQ
; Fei GJ
Chin Med J (Engl)
2016[Jun]; 129
(11
): 1330-3
PMID27231171
show ga
BACKGROUND: Tuberculosis (TB) remains a worldwide problem. Intestinal TB (ITB)
constitutes a major public health problem in developing countries and has been
associated with significant morbidity and mortality. The aim of this study was to
characterize the clinical, radiological, endoscopic, and pathological features of
ITB and to define the strategy for establishing the diagnosis. METHODS: A
retrospective study (from January 2000 to June 2015) was carried out in Peking
Union Medical College Hospital and all hospitalized cases were diagnosed as ITB
during the study period were included. The relevant clinical information,
laboratory results, microbiological, and radiological investigations were
recorded. RESULTS: Of the 85 cases, 61 cases (71.8%) were ranged from 20 to 50
years. The ileocecal region was involved in about 83.5% (71/85) of patients.
About 41.2% (35/85) of patients had co-existing extra ITB, especially active
pulmonary TB. Abdominal pain (82.4%) was the most common presenting symptom
followed by weight loss (72.9%) and fever (64.7%). Both T-cell spot of TB test
(T-SPOT.TB) and purified protein derivatives (PPD) tests were performed in 26
patients: 20 (76.9%) positive T-SPOT.TB and 13 (50.0%) positive PPD were
detected, with a statistical significant difference (P = 0.046). Twenty cases
(23.5%) were histopathology and/or pathogen confirmed TB; 27 cases (31.8%) were
diagnosed by clinical manifestation consistent with ITB and evidence of active
extra ITB; 38 cases (44.7%) were diagnosed by good response to diagnostic anti-TB
therapy. CONCLUSIONS: ITB is difficult to diagnose even with modern medical
techniques due to its nonspecific clinical and laboratory features. At present,
combination of clinical, endoscopic, radiological, and pathological features
continues to be the key to the diagnosis of ITB.