title: Differential diagnosis between Crohn's disease and intestinal tuberculosis using integrated parameters including clinical manifestations, T-SPOT, endoscopy and CT enterography.
abstract: BACKGROUND
  The aim of the study was to evaluate clinical manifestations, T-SPOT, endoscopy and CT enterography to differentiate Crohn's disease (CD) from intestinal tuberculosis (ITB).
  
  
  METHODS
  128 in patients with suspected CD and ITB were prospectively enrolled in the study. Demographic, clinical, laboratory, endoscopic and CT enterographic data were collected. After treatment for 6 months, when a definite diagnosis was reached, the differential diagnostic value of each parameter was analyzed. Multivariable logistic regression was used to analyze further, parameters of statistical significance to establish a mathematical regression equation. Receiver operating characteristic curves were plotted.
  
  
  RESULTS
  Clinical parameters helpful in differentiating CD from ITB included diarrhea, night sweat and perianal disease. Endoscopic parameters were useful in differentiating CD from ITB including transverse ulcers, longitudinal ulcers, rodent-like ulcers and patulous ileocecal valve. CT enterographic parameters aided the identification of the two conditions. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of a mathematical regression model established for 6 parameters of clinical endoscopy and CT enterography were 97.8%, 96.8%, 97.6%, 98.9% and 93.7% respectively, whereas those for T-SPOT were 96.8%, 91.3%, 92.7%, 78.9% and 98.8% respectively.
  
  
  CONCLUSIONS
  T-SPOT is useful to exclude a diagnosis of ITB. Differentiating CD from ITB is a difficult clinical problem that requires a consideration of clinical, T-SPOT, endoscopic and CT enterographic parameters for accurate diagnosis.
authors.affiliation: Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors.forename: Tianyu
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Fan
authors.affiliation: Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors.forename: Zhengting
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors.forename: Shurong
authors.initials: S
authors.lastname: Hu
authors.affiliation: Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors.forename: Maochen
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors.forename: Yonghua
authors.initials: Y
authors.lastname: Tang
authors.affiliation: Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhong
keywords: Crohn’s disease; Intestinal tuberculosis; differential diagnosis