Usefulness of C-reactive Protein Level before and during Antimycobacterial Therapy in the Differential Diagnosis between Crohn's Disease and Intestinal Tuberculosis |
Sang Hyun Park, Suk-Kyun Yang, Seung-Jae Myung, Jeong-Sik Byeon, Byongduk Ye, Seunghyun Kwon, Benjamin Kim, Soon Man Yoon, Mi Young Do, Do Hoon Kim, Sai-Hui Kim, Jin Ho Kim |
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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항결핵제 투여 후 C-reactive Protein 측정을 통한 크론병과 장결핵의 감별진단 |
박상현, 양석균, 명승재, 변정식, 예병덕, 권승현, 김병규, 윤순만, 도미영, 김도훈, 김세희, 김진호 |
울산대학교 의과대학 서울아산병원 내과학교실 |
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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) |
Key Words:
Crohn disease, Tuberculosis, Gastrointestinal, Antimycobacterial, CRP |
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