Tuberculosis intestinal secundaria a uso de terapia biológica: ¿puede mimetizar la enfermedad de Crohn?
https://orcid.org/0000-0002-3108-0424
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The Intestinal tuberculosis (ITB) and Crohn’s disease (CD) are chronic granulomatous disorders, that could have a transmural compromiso. They can affect any part of the digestive system. Both have similar symptoms looking at them from a clinical, radiological, endoscopical and histological point of view.
I presented two cases of patients where the initial suggestive diagnosis was Crohn’s disease. Confirmed with ileocolonic involvement based on clinical data, endoscopical, serological and histological findings.
However, patients had a poor clinical response to the conventional therapies used in the treatment of CD, even with the implementation of steroids. At the begining , in both cases is descarted systemic infectios. Patients started inmunosuppressive therapies with the use of azathioprine and antibodies against tumor necrosis factor alpha (TNFa inhibitor). As a result, the patients developed disseminated forms of the tuberculosis. They did not show improvement of the gastrointestinal symptoms. But, they had a satisfactory response with respect to the infectios and digestive symptoms, when they used the antituberculous. The conclusion was, a diagnosis of intestinal tuberculosis mimicking Crohn’s disease.
Enfermedad de Crohn, tuberculosis, inmunosupresión, diagnostico diferencialCrohn´s disease, tuberculosis, inmunosuppression, diferential diagnostic.
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