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Visceral Fat as a Useful Parameter in the Differential Diagnosis of Crohn's Disease and Intestinal Tuberculosis
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Jun Kwon Ko, Hang Lak Lee, Jin Ok Kim, Soon Young Song, Kang Nyeong Lee, Dae Won Jun, Oh Young Lee, Dong Soo Han, Byung Chul Yoon, Ho Soon Choi, Joon Soo Hahm, Sang-Yeon Kim
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Intest Res 2014;12(1):42-47. Published online January 28, 2014
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DOI: https://doi.org/10.5217/ir.2014.12.1.42
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 Abstract
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- <b>Background/Aims</b><br/>
Because of the similarities in the clinical presentations of Crohn's disease (CD) and intestinal tuberculosis (ITB), differential diagnosis is critical. Mesenteric adipose tissue hypertrophy and creeping fat are characteristic features of CD. The purpose of this study was to assess the usefulness of visceral fat for the differential diagnosis of CD and ITB. MethodsWe conducted a retrospective review of 50 patients with findings of CD or ITB between January 2005 and July 2008. Abdominal computed tomography (CT) was performed on all subjects during their first evaluation. The abdominal fat area was assessed using quantitative abdominal CT. ResultsThe ratio of visceral fat to total fat (VF/TF) was significantly higher in male CD patients than in male ITB patients. The ratio of visceral fat to subcutaneous fat (VF/SF) was also higher in CD patients than in patients with ITB. For a VF/TF cut-off value of 0.46, the sensitivity and specificity for the diagnosis of CD were 42.1% and 93.3% respectively, with positive and negative predictive values of 88.9% and 56.0%, respectively. ConclusionMeasurement of the abdominal fat area using CT can be clinically useful for the differential diagnosis of CD and ITB.
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Citations
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Lugen Zuo, Sitang Ge, Yuanyuan Ge, Jingjing Li, Bing Zhu, Zongbing Zhang, Congqiao Jiang, Jing Li, Suanhu Wang, Mulin Liu, Shiqing Li, Rong Wu, Jianguo Hu
Journal of Crohn's and Colitis.2019; 13(7): 931. CrossRef - Indian guidelines on imaging of the small intestine in Crohn’s disease: A joint Indian Society of Gastroenterology and Indian Radiology and Imaging Association consensus statement
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Indian Journal of Radiology and Imaging.2019; 29(02): 111. CrossRef - Serum proteome profiles to differentiate Crohn disease from intestinal tuberculosis and primary intestinal lymphoma
Longgui Ning, Guodong Shan, Zeyu Sun, Xinhe Lou, Fenming Zhang, Sha Li, Haojie Du, Jinghua Yu, Hongtan Chen, Guoqiang Xu
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Qi Feng, Xi Tao Xu, Yi Zhou, Yun Qi Yan, Zhi Hua Ran, Jiong Zhu
Journal of Digestive Diseases.2018; 19(8): 475. CrossRef - Making a Positive Diagnosis of Intestinal Tuberculosis with the Aid of New Biologic and Histologic Features: How Far Have We Reached?
Vatsal Mehta, Devendra Desai, Philip Abraham, Camilla Rodrigues
Inflammatory Intestinal Diseases.2018; 3(4): 155. CrossRef - Accuracy of computed tomographic features in differentiating intestinal tuberculosis from Crohn's disease: a systematic review with meta-analysis
Saurabh Kedia, Raju Sharma, Vishnubhatla Sreenivas, Kumble Seetharama Madhusudhan, Vishal Sharma, Sawan Bopanna, Venigalla Pratap Mouli, Rajan Dhingra, Dawesh Prakash Yadav, Govind Makharia, Vineet Ahuja
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Dawesh Prakash Yadav, Kumble Seetharama Madhusudhan, Saurabh Kedia, Raju Sharma, Venigalla Pratap Mouli, Sawan Bopanna, Rajan Dhingra, Rajesh Pradhan, Sandeep Goyal, Vishnubhatla Sreenivas, Naval K Vikram, Govind Makharia, Vineet Ahuja
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Saurabh Kedia, Raju Sharma, Govind K. Makharia, Vineet Ahuja, Devendra Desai, Devasenathipathy Kandasamy, Anu Eapen, Karthik Ganesan, Uday C. Ghoshal, Naveen Kalra, D. Karthikeyan, Kumble Seetharama Madhusudhan, Mathew Philip, Amarender Singh Puri, Sunil
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Jia Yi Ma, Jin Lu Tong, Zhi Hua Ran
Journal of Digestive Diseases.2016; 17(3): 155. CrossRef - Change in the diagnosis of inflammatory bowel disease: a hospital-based cohort study from Korea
Ho-Su Lee, Jaewon Choe, Hyo Jeong Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Yong Sik Yoon, Chang Sik Yu, Jin-Ho Kim, Suk-Kyun Yang
Intestinal Research.2016; 14(3): 258. CrossRef
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Cyclooxgenase-2 Expression in Chronic Inflammatory Bowel Disease: Comparing of Immunohistochemical Stain to Real-time PCR
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Young Sook Park, Nam In Kim, Jun Seok Lee, Jeoung Ho Choi, Chae Young Im, Dae Won Jun, Yun Ju Jo, Seung Hwan Kim, Byung Kwan Son, Won Mee Lee, Eun Kyoung Kim
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Intest Res 2008;6(2):128-134. Published online December 30, 2008
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Abstract
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- Background/Aims
This study compared the results of cyclooxygenase-2 (COX-2) expression in inflammatory bowel disease and tuberculous colitis as evident by immunochemical staining and real time polymerase chain reaction (PCR). Methods: Patients with ulcerative colitis (n=18), Crohn's disease (n=7), tuberculous colitis (n=7) and 10 normal controls were included. Biopsied colonic mucosa was simultaneously used for immunohistochemical staining and real time PCR. Results: Patients with inflammatory bowel disease and tuberculous colitis showed high COX-2 expression by both methods compared to the normal controls. In Crohn's disease patients, the real time PCR value correlated well staining grade; this correlation was not evident in ulcerative colitis patients. In real time PCR, grossly normal colonic mucosa in ulcerative colitis also showed higher expression of COX-2 than normal mucosa. Conclusions: Real time PCR value of COX-2 is more representative of inflammation state in inflammatory bowel disease than the value from immunohistochemical staining. (Intest Res 2008;6:128-134)
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A Case of Ulcerative Colitis with Prolonged Remission Following Azathioprine-Induced Pancytopenia
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Jun Seok Lee, Young Sook Park, Nam In Kim, Yoon Ju Jo, Seung Hwan Kim, Han Hyo Lee, Moon Hee Song, Dae Won Jun
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Intest Res 2008;6(1):85-89. Published online June 30, 2008
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Abstract
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- Azathioprine (AZA) is widely used for the treatment of inflammatory bowel disease. Bone marrow suppression is a common side effect with AZA treatment. However, data from AZA trials has indicated that a leukocyte count less than 5,000/mm3 was a good predictor of induction and maintenance of remission. Moreover, there is evidence that eradication of sensitized leukocytes by leukapheresis or bone marrow transplantation improves inflammatory bowel disease. We report a case of a patient who had a chronic relapse of ulcerative colitis requiring the frequent use of systemic steroids, but presented prolonged remission following AZA-induced severe pancytopenia. Also colonoscopy showed accelerated healing of diffuse active ulcers following just recovery from pancytopenia. (Intest Res 2008;6:85-89)
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