{Reference Type}: Journal Article
{Title}: An outcome-based composite approach for the diagnosis of intestinal tuberculosis: a pilot study from a tertiary care centre in South India.
{Author}: Paulose RR;Kumar VA;Sharma A;Damle A;Saikumar D;Sudhakar A;Koshy AK;Damle RPVP;
{Journal}: J R Coll Physicians Edinb
{Volume}: 51
{Issue}: 4
{Year}: Dec 2021
暂无{DOI}: 10.4997/JRCPE.2021.406
{Abstract}: <B>BACKGROUND: </B>The diagnosis of intestinal TB (ITB) is challenging because of its overlapping features with Crohn's disease. This outcome-based study evaluated the combination of colonoscopy, histopathology, Xpert MTB/RIF and TB culture for best sensitivity and specificity.<BR><B>METHODS: </B>This was a four-year retrospective, observational study of 426 clinically suspected patients who underwent colonoscopy with biopsies for histopathology, Xpert MTB/RIF and TB culture. ITB was diagnosed using the composite reference standard (CRS), which comprised either histological features or culture or Xpert MTB/RIF positivity, and positive response to anti-tuberculous treatment on follow up.<BR><B>RESULTS: </B>35 (8.2%) patients were diagnosed with ITB. Histopathology had the highest sensitivity (91.4%) and negative predictive value (99.2%), MTB/RIF had the highest specificity (100%) and positive predictive value (100%). A combinatorial approach with Xpert MTB/RIF and histopathology had optimal diagnostic value (97%), approaching 100% sensitivity with culture. 40% of cases were diagnosed within 12 hours with Xpert MTB/RIF and 97% cases within three days.<BR><B>CONCLUSIONS: </B>This combinatorial diagnostic model provides rapid and reliable diagnosis of ITB which may be useful in endemic areas.