Predictive Factors for Differentiating Between Crohn's Disease and Intestinal Tuberculosis in Koreans.
A differential diagnosis between intestinal tuberculosis (ITB) and Crohn's disease (CD) is challenging. The aim of this study was to investigate the clinical, endoscopic, and histological features and to create a predictive score model for differentiating CD and ITB.



In total, 261 patients, 99 with ITB and 162 with CD, were recruited from seven tertiary centers from 2005 to 2013 and reviewed retrospectively. For the creation of a validated model, parameters were selected by univariate logistic regression and receiver operating characteristic curve analyses. Then, the prediction model was established on the basis of β-coefficients of the multivariate logistic regression. For the validation of the model, the same regression equation was tested on the other group.



Age, diarrhea, ring-shaped ulcer, longitudinal ulcer, sigmoid involvement, suspicious radiological pulmonary tuberculosis, and gender were selected as the factors for a seven-marker model. In the seven-marker model of the validation data set, the sensitivity, specificity, positive predictive value, and negative predictive value with a cutoff level of 0.35 were 98.0, 92.4, 88.9, and 98.6, respectively.



The seven-marker model seems to be highly reliable for differentiating between ITB and CD and could be conveniently used by clinicians to obtain results.
Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan-si, Chungcheongnam-do, South Korea.
Yunho
Y
Jung
Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan-si, Chungcheongnam-do, South Korea.
Young
Y
Hwangbo
Department of Internal Medicine, Chungbuk National University Hospital, Cheongju-si, Chungcheongbuk-do, South Korea.
Soon Man
SM
Yoon
Department of Internal Medicine, Konyang University of Medicine, Daejeon, South Korea.
Hoon Sup
HS
Koo
Department of Internal Medicine, Dankook University College of Medicine, Cheonan-si, Chungcheongnam-do, South Korea.
Hyun Deok
HD
Shin
Department of Internal Medicine, Dankook University College of Medicine, Cheonan-si, Chungcheongnam-do, South Korea.
Jeong Eun
JE
Shin
Department of Internal Medicine, Chungnam National University Hospital, Daejeon, South Korea.
Hee Seok
HS
Moon
Department of Internal Medicine, Daejeon St Mary's Hospital, College of Medicine, Daejeon, South Korea.
Sang Bum
SB
Kang
Department of Internal Medicine, Konkuk University School of Medicine, Chungju-si, Chungcheongbuk-do, South Korea.
Jeong Rok
JR
Lee
Department of Internal Medicine, Konyang University of Medicine, Daejeon, South Korea.
Kyu Chan
KC
Huh
D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001004:Anus Diseases / Q000209:etiology*; D003113:Colonoscopy; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D013902:Radiography, Thoracic; D056910:Republic of Korea; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012737:Sex Factors; D012810:Sigmoid Diseases / Q000209:etiology*; D014385:Tuberculosis, Gastrointestinal / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging*; D014456:Ulcer / Q000209:etiology / Q000473:pathology*; D055815:Young Adult