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Revista colombiana de Gastroenterología
versão impressa ISSN 0120-9957versão On-line ISSN 2500-7440
Resumo
REVELO-MORENO, Santiago; GOMEZ-SUTA, Luz Daniela e GUEVARA-GUZMAN, Jairo Alfredo. Crohn’s Disease in a Patient with Tuberculosis: A Diagnostic and Therapeutic Challenge. Rev. colomb. Gastroenterol. [online]. 2023, vol.38, n.3, pp.378-382. Epub 19-Jan-2024. ISSN 0120-9957. https://doi.org/10.22516/25007440.969.
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.
Palavras-chave : Crohn’s disease; tuberculosis; differential diagnosis.