Fluorescent quantitative PCR of Mycobacterium
tuberculosis for differentiating intestinal tuberculosis from
Crohn's disease |
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Authors: | BY Fei HX Lv WH Zheng |
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Institution: | 1. Department of Gastroenterology, Zhejiang Province People''s Hospital, Hangzhou, China, Department of Gastroenterology, Zhejiang Province People''s Hospital, Hangzhou, Zhejiang Province, China;2. Department of Clinical Laboratory, Zhejiang Province People''s Hospital, Hangzhou, China, Department of Clinical Laboratory, Zhejiang Province People''s Hospital, Hangzhou, Zhejiang Province, China |
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Abstract: | Intestinal tuberculosis (ITB) and Crohn''s disease (CD) are granulomatous
disorders with similar clinical manifestations and pathological features that
are often difficult to differentiate. This study evaluated the value of
fluorescent quantitative polymerase chain reaction (FQ-PCR) for
Mycobacterium tuberculosis (MTB) in fecal samples and
biopsy specimens to differentiate ITB from CD. From June 2010 to March 2013, 86
consecutive patients (38 females and 48 males, median age 31.3 years) with
provisional diagnoses of ITB and CD were recruited for the study. The patients''
clinical, endoscopic, and histological features were monitored until the final
definite diagnoses were made. DNA was extracted from 250 mg fecal samples and
biopsy tissues from each patient. The extracted DNA was amplified using FQ-PCR
for the specific MTB sequence. A total of 29 ITB cases and 36 CD cases were
included in the analysis. Perianal disease and longitudinal ulcers were
significantly more common in the CD patients (P<0.05), whereas night sweats,
ascites, and circumferential ulcers were significantly more common in the ITB
patients (P<0.05). Fecal FQ-PCR for MTB was positive in 24 (82.8%) ITB
patients and 3 (8.3%) CD patients. Tissue PCR was positive for MTB in 16 (55.2%)
ITB patients and 2 (5.6%) CD patients. Compared with tissue FQ-PCR, fecal FQ-PCR
was more sensitive (X2=5.16, P=0.02). We conclude that FQ-PCR for MTB
on fecal and tissue samples is a valuable assay for differentiating ITB from CD,
and fecal FQ-PCR has greater sensitivity for ITB than tissue FQ-PCR. |
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Keywords: | Intestinal tuberculosis Crohn''s disease Diagnosis Fluorescent quantitative PCR Mycobacterium tuberculosis |
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