title: Differentiation of Crohn's disease from intestinal tuberculosis in India in 2010.
abstract: 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.
authors.affiliation: Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India. annapulimood@cmcvellore.ac.in
authors.forename: Anna Benjamin
authors.initials: AB
authors.lastname: Pulimood
authors.forename: Deepak Narayan
authors.initials: DN
authors.lastname: Amarapurkar
authors.forename: Ujjala
authors.initials: U
authors.lastname: Ghoshal
authors.forename: Mathew
authors.initials: M
authors.lastname: Phillip
authors.forename: Cannanore Ganesh
authors.initials: CG
authors.lastname: Pai
authors.forename: Duvvur Nageshwar
authors.initials: DN
authors.lastname: Reddy
authors.forename: Birender
authors.initials: B
authors.lastname: Nagi
authors.forename: Balakrishna Siddhartha
authors.initials: BS
authors.lastname: Ramakrishna
mesh_terms: D053704:Capsule Endoscopy; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007194:India; D009169:Mycobacterium tuberculosis / Q000235:genetics; D011859:Radiography / Q000379:methods; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy