Analysis of Phenotypic Variables and Differentiation Between Untypical Crohn's Disease and Untypical Intestinal Tuberculosis
Meng Y, Li Y, Hao R, Li X, Lu F
Digestive diseases and sciences · 2019-02
Abstract
Background The differentiation between untypical intestinal tuberculosis (UITB) and untypical Crohn's disease (UCD) is a challenge. Aims To analyze phenotypic variables and propose a novel prediction model for differential diagnosis of two conditions. Methods A total of 192 patients were prospectively enrolled. The clinical, laboratory, endoscopic, and radiological features were investigated and subjected to univariable and multivariable analyses. The final prediction model for differentiation between UCD and UITB was developed by logistic regression analysis and Fisher discriminant analysis on the training set. The same discriminant function was tested on the validation set. Results Twenty-five candidates were selected from 52 phenotypic variables of typical Crohn's disease (TCD), UCD, and UITB patients. UCD's variables overlapped with both TCD and UITB. The percentages of tuberculosis history, positive PPD, and positive T-SPOT result in UCD were all significantly higher than that in TCD (11.6% vs. 0.0%, 27.9% vs. 0.0%, 25.6% vs. 4.5%, respectively, P Conclusions Phenotypes of UCD patients in TB-endemic countries may be associated with TB infection history. Fisher discriminant analysis is a good choice to differentiate UCD from UITB, which is worthy of verification in clinical practice.
MeSH terms
- Intestines
- Humans
- Tuberculosis, Gastrointestinal
- Crohn Disease
- Diagnosis, Differential
- Endoscopy, Gastrointestinal
- Discriminant Analysis
- Prospective Studies
- Reproducibility of Results
- Predictive Value of Tests
- Phenotype
- Decision Support Techniques
- Interferon-gamma Release Tests
- Biomarkers