Crohn’s Disease in a Patient with Tuberculosis: A Diagnostic and Therapeutic Challenge

Authors

DOI:

https://doi.org/10.22516/25007440.969

Keywords:

Crohn's disease, tuberculosis, differential diagnosis

Abstract

Introduction: Crohn’s disease (CD) is unusual in Colombia. Tuberculosis (TB) occurs more frequently, but intestinal involvement is rare. Differentiating these two entities and treating the cases in which they coexist is a challenge.

Clinical case: A 28-year-old man with three months of constitutional, respiratory, and GI symptoms was initially diagnosed with pulmonary tuberculosis, and all the clinical manifestations were attributed to this entity. Given the absence of improvement with treatment and the sum of radiological, endoscopic, and pathological findings, CD was confirmed. Treatment was complex due to the coexistence of the two entities, although he finally went into remission with the use of biologicals.

Discussion: Diagnosing CD requires the sum of clinical and paraclinical findings. A therapeutic test may be necessary to differentiate it from intestinal TB. The treatment of CD in a patient with TB has some limitations; steroids are not contraindicated, and biologicals must be initiated cautiously.

Conclusions: Differentiating CD from intestinal TB is a diagnostic challenge. Therapeutic management when these two entities coexist requires an interdisciplinary approach.

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Author Biographies

Santiago Revelo Moreno, Medicina Interna

Médico, Especialista en Medicina Interna de la Universidad Tecnológica de Pereria, Centro Médico Colsubsidio Sura (PAC) Bogotá D.C

Luz Daniela Gómez Suta, Medicina Interna

Médico, Residente de Medicina Interna de la Universidad Tecnológica de Pereira

Jairo Alfredo Guevara Guzmán, Medicina Interna, Gastroenterología

Médico, especialista en Medicina Interna, Gastroenterología y Endoscopia Digestiva de la Universidad Militar Nueva Granada. Docente de Gastroenterología de la Universidad Tecnológica de Pereira, Gastro Elite S.A.S Pereira.

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Figure 1. MRE with contrast. A. In the arterial phase: thickening of the ileus (+). B. In the portal phase: thickening of the ileum with a wall of 13 millimeters. Image owned by the authors.

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Published

2023-09-27

How to Cite

Revelo Moreno, S., Gómez Suta, L. D., & Guevara Guzmán, J. A. (2023). Crohn’s Disease in a Patient with Tuberculosis: A Diagnostic and Therapeutic Challenge. Revista Colombiana De Gastroenterología, 38(3), 378–382. https://doi.org/10.22516/25007440.969

Issue

Vol. 38 No. 3 (2023): July - September

Section

Case report

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