An outcome-based composite approach for the diagnosis of intestinal tuberculosis : a pilot study from a tertiary care centre in South India
BACKGROUND: 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.
METHOD: 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.
RESULTS: 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.
CONCLUSION: This combinatorial diagnostic model provides rapid and reliable diagnosis of ITB which may be useful in endemic areas.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:51 |
|---|---|
| Enthalten in: |
The journal of the Royal College of Physicians of Edinburgh - 51(2021), 4 vom: 22. Dez., Seite 344-350 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Paulose, Roopa Rachel [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Colonoscopy |
|---|
| Anmerkungen: |
Date Completed 26.01.2022 Date Revised 26.01.2022 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.4997/JRCPE.2021.406 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM334186951 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM334186951 | ||
| 003 | DE-627 | ||
| 005 | 20231225223156.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.4997/JRCPE.2021.406 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1113.xml |
| 035 | |a (DE-627)NLM334186951 | ||
| 035 | |a (NLM)34882131 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Paulose, Roopa Rachel |e verfasserin |4 aut | |
| 245 | 1 | 3 | |a An outcome-based composite approach for the diagnosis of intestinal tuberculosis |b a pilot study from a tertiary care centre in South India |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 26.01.2022 | ||
| 500 | |a Date Revised 26.01.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: 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 | ||
| 520 | |a METHOD: 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 | ||
| 520 | |a RESULTS: 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 | ||
| 520 | |a CONCLUSION: This combinatorial diagnostic model provides rapid and reliable diagnosis of ITB which may be useful in endemic areas | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Crohn’s disease | |
| 650 | 4 | |a TB culture | |
| 650 | 4 | |a Xpert MTB/RIF | |
| 650 | 4 | |a colonoscopy | |
| 650 | 4 | |a histopathology | |
| 650 | 4 | |a intestinal tuberculosis | |
| 700 | 1 | |a Kumar, V Anil |e verfasserin |4 aut | |
| 700 | 1 | |a Sharma, Aparna |e verfasserin |4 aut | |
| 700 | 1 | |a Damle, Aditi |e verfasserin |4 aut | |
| 700 | 1 | |a Saikumar, Divya |e verfasserin |4 aut | |
| 700 | 1 | |a Sudhakar, Abish |e verfasserin |4 aut | |
| 700 | 1 | |a Koshy, Anoop K |e verfasserin |4 aut | |
| 700 | 1 | |a Damle, Rama P Venu P |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The journal of the Royal College of Physicians of Edinburgh |d 2002 |g 51(2021), 4 vom: 22. Dez., Seite 344-350 |w (DE-627)NLM122212967 |x 2042-8189 |7 nnns |
| 773 | 1 | 8 | |g volume:51 |g year:2021 |g number:4 |g day:22 |g month:12 |g pages:344-350 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.4997/JRCPE.2021.406 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 51 |j 2021 |e 4 |b 22 |c 12 |h 344-350 | ||