Abstract

Background/Aims
Crohn's disease (CD) and intestinal tuberculosis (TB) are chronic inflammatory bowel disorders that are difficult to differentiate. Therefore, a therapeutic trial of antimycobacterial drugs is often used to differentiate CD from TB. This study aimed to evaluate the usefulness of C-reactive protein (CRP) level before or during antimycobacterial therapy to differentiate CD from TB. Methods: A total of 26 CD patients and 52 TB patients who received antimycobacterial therapy at the Asan Medical Center were included. CRP levels before or during antimycobacterial therapy were compared between CD and TB patients. A positive response to antimycobacterial therapy was defined as the decrease of CRP level below 50% of its baseline value. Results: The baseline CRP level was normal in only 1 of 26 CD patients (3.8%), while it was in 26 of 52 TB patients (50%). The rate of positive response to antimycobacterial therapy was significantly different between CD and TB patients whose baseline CRP level was abnormal: 28.0% (7/25) vs 88.5% (23/26) in 2 weeks, 34.8% (8/23) vs 84.6% (22/26) in 4 weeks, and 43.5% (10/23) vs 92.3% (24/26) in 8 weeks of antimycobacterial therapy. The rate of normalization in CRP level was also significantly different between the two groups: 0% (0/25) vs 73.1% (19/26) in 2 weeks, 13.0% (3/23) vs 69.2% (18/26) in 4 weeks, and 8.7% (2/23) vs 80.8% (21/26) in 8 weeks of antimycobacterial therapy. Conclusions: The CRP level before and during antimycobacterial therapy may be used as a supplementary tool in the differential diagnosis between CD and TB patients. (Intest Res 2007;5:19-25)

• Keywords: Crohn disease; Tuberculosis, Gastrointestinal; Antimycobacterial; CRP