Skip to main content

Differential Diagnosis of Inflammatory Bowel Disease

  • Chapter
  • First Online:

Abstract

Numerous diseases can present with symptoms similar to IBD. In case of acute-onset diarrhea, infectious or allergic diseases and acute appendicitis should be ruled out before considering the diagnosis of IBD. Chronic or recurrent intestinal symptoms are more suggestive of IBD. Infection, celiac disease, or food allergy should all be entertained in the differential diagnosis in this situation. Neoplasm and vasculitic disorders are more rarely involved. Disorders of the immune system should be sought after, especially in cases of early-onset (<6 years) symptoms, as numerous monogenic disorders are currently being discovered with specific therapeutic options available. Less classic presentations of IBD can be encountered, leading to consideration of other diagnoses such as tumors or tuberculosis in cases of an abdominal mass, peptic disease in cases of isolated esophagogastroduodenal involvement, immunodeficiency syndromes, or trauma in cases of isolated perianal/perineal disease.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Schumacher G, Sandstedt B, Kollberg B. A prospective study of first attacks of inflammatory bowel disease and infectious colitis. Clinical findings and early diagnosis. Scand J Gastroenterol. 1994;29(3):265–74.

    Article  CAS  PubMed  Google Scholar 

  2. Rutgeerts P, Peeters M, Geboes K, et al. Infectious agents in inflammatory bowel disease. Endoscopy. 1992;24(6):565–7.

    Article  CAS  PubMed  Google Scholar 

  3. Surawicz CM, Belic L. Rectal biopsy helps to distinguish acute self-limited colitis from idiopathic inflammatory bowel disease. Gastroenterology. 1984;86(1):104–13.

    CAS  PubMed  Google Scholar 

  4. Nostrant TT, Kumar NB, Appelman HD. Histopathology differentiates acute self-limited colitis from ulcerative colitis. Gastroenterology. 1987;92(2):318–28.

    Article  CAS  PubMed  Google Scholar 

  5. Notteghem B, Salomez JL, Gower-Rousseau C, et al. What is the prognosis in unclassified colitis? Results of a cohort study of 104 patients in the Northern-Pas-de-Calais region. Gastroenterol Clin Biol. 1993;17(11):811–5.

    CAS  PubMed  Google Scholar 

  6. Goldman H, Proujansky R. Allergic proctitis and gastroenteritis in children. Clinical and mucosal biopsy features in 53 cases. Am J Surg Pathol. 1986;10(2):75–86.

    Article  CAS  PubMed  Google Scholar 

  7. Hill SM, Milla PJ, Phillips AD, et al. Colitis caused by food allergy in infants. Arch Dis Child. 1990;65(1):132–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Jenkins HR, Pincott JR, Soothill JF, et al. Food allergy: the major cause of infantile colitis. Arch Dis Child. 1984;59(4):326–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Odze RD, Bines J, Leichtner AM, et al. Allergic proctocolitis in infants: a prospective clinicopathologic biopsy study. Hum Pathol. 1993;24(6):668–74.

    Article  CAS  PubMed  Google Scholar 

  10. Rosekrans PC, Meijer CJ, van der Wal AM, et al. Allergic proctitis, a clinical and immunopathological entity. Gut. 1980;21(12):1017–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Boyce JA, Assa’a A, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126:S1–S58.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Fonkalsrud EW, Ament ME, Fleisher D. Management of the appendix in young patients with Crohn's disease. Arch Surg. 1982;117(1):11–4.

    Article  CAS  PubMed  Google Scholar 

  13. Yang SS, Gibson P, McCaughey RS, et al. Primary Crohn's disease of the appendix: report of 14 cases and review of the literature. Ann Surg. 1979;189(3):334–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Yokota S, Togashi K, Kasahara N, et al. Crohn’s disease confined to the appendix. Gastrointest Endosc. 2010;72(5):1063–4.

    Article  PubMed  Google Scholar 

  15. McOmber ME, Shulman RJ. Recurrent abdominal pain and irritable bowel syndrome in children. Curr Opin Pediatr. 2007;19(5):581–5.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Diamanti A, Panetta F, Basso MS, et al. Diagnostic work-up of inflammatory bowel disease in children: the role of calprotectin assay. Inflamm Bowel Dis. 2010;16(11):1926–30.

    Article  CAS  PubMed  Google Scholar 

  17. Tedesco FJ, Hardin RD, Harper RN, Edwards BH. Infectious colitis endoscopically simulating inflammatory bowel disease: a prospective evaluation. Gastrointest Endosc. 1983;29(3):195–7.

    Article  CAS  PubMed  Google Scholar 

  18. Marks MI, Pai CH, Lafleur L, et al. Yersinia enterocolitica gastroenteritis: a prospective study of clinical, bacteriologic, and epidemiologic features. J Pediatr. 1980;96(1):26–31.

    Article  CAS  PubMed  Google Scholar 

  19. Abdel-Haq NM, Asmar BI, Abuhammour WM, et al. Yersinia enterocolitica infection in children. Pediatr Infect Dis J. 2000;19(10):954–8.

    Article  CAS  PubMed  Google Scholar 

  20. Matsumoto T, Iida M, Matsui T, et al. Endoscopic findings in Yersinia enterocolitica enterocolitis. Gastrointest Endosc. 1990;36(6):583–7.

    Article  CAS  PubMed  Google Scholar 

  21. Puylaert JB, Van der Zant FM, Mutsaers JA. Infectious ileocecitis caused by Yersinia, Campylobacter, and Salmonella: clinical, radiological and US findings. Eur Radiol. 1997;7(1):3–9.

    Article  CAS  PubMed  Google Scholar 

  22. Bhan MK, Raj P, Levine MM, et al. Enteroaggregative Escherichia coli associated with persistent diarrhea in a cohort of rural children in India. J Infect Dis. 1989;159(6):1061–4.

    Article  CAS  PubMed  Google Scholar 

  23. Fang GD, Lima AA, Martins CV, et al. Etiology and epidemiology of persistent diarrhea in northeastern Brazil: a hospital-based, prospective, case-control study. J Pediatr Gastroenterol Nutr. 1995;21(2):137–44.

    Article  CAS  PubMed  Google Scholar 

  24. Gryboski JD. Clostridium difficile in inflammatory bowel disease relapse. J Pediatr Gastroenterol Nutr. 1991;13(1):39–41.

    Article  CAS  PubMed  Google Scholar 

  25. Greenfield C, Aguilar Ramirez JR, Pounder RE, et al. Clostridium difficile and inflammatory bowel disease. Gut. 1983;24(8):713–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Meyers S, Mayer L, Bottone E, et al. Occurrence of Clostridium difficile toxin during the course of inflammatory bowel disease. Gastroenterology. 1981;80(4):697–700.

    CAS  PubMed  Google Scholar 

  27. Pickering LK, Engelkirk PG. Giardia lamblia. Pediatr Clin North Am. 1988;35(3):565–77.

    Article  CAS  PubMed  Google Scholar 

  28. Ament ME, Rubin CE. Relation of giardiasis to abnormal intestinal structure and function in gastrointestinal immunodeficiency syndromes. Gastroenterology. 1972;62(2):216–26.

    CAS  PubMed  Google Scholar 

  29. Levinson JD, Nastro LJ. Giardiasis with total villous atrophy. Gastroenterology. 1978;74(2 Pt 1):271–5.

    CAS  PubMed  Google Scholar 

  30. Dunzendorfer T, Kasznica J. Amebic and/or ulcerative colitis? Gastrointest Endosc. 1998;48(4):450–1.

    Article  CAS  PubMed  Google Scholar 

  31. Ibrahim TM, Iheonunekwu N, Gill V, et al. Differentiating amoebic ulcero-haemorrhagic recto-colitis from idiopathic inflammatory bowel disease: still a diagnostic dilemma. West Indian Med J. 2005;54(3):210–2.

    Article  CAS  PubMed  Google Scholar 

  32. Gupta SS, Singh O, Shukla S, Raj MK. Acute fulminant necrotizing amoebic colitis: a rare and fatal complication of amoebiasis: a case report. Cases J. 2009;2:6557.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Almadi MA, Ghosh S, Aljebreen AA. Differentiating intestinal tuberculosis from Crohn's disease: a diagnostic challenge. Am J Gastroenterol. 2009;104(4):1003–12.

    Article  PubMed  Google Scholar 

  34. Jain R, Sawhney S, Bhargava DK, et al. Diagnosis of abdominal tuberculosis: sonographic findings in patients with early disease. AJR Am J Roentgenol. 1995;165(6):1391–5.

    Article  CAS  PubMed  Google Scholar 

  35. Malik A, Saxena NC. Ultrasound in abdominal tuberculosis. Abdom Imaging. 2003;28(4):574–9.

    Article  CAS  PubMed  Google Scholar 

  36. Makanjuola D. Is it Crohn’s disease or intestinal tuberculosis? CT analysis. Eur J Radiol. 1998;28(1):55–61.

    Article  CAS  PubMed  Google Scholar 

  37. Sinan T, Sheikh M, Ramadan S, et al. CT features in abdominal tuberculosis: 20 years experience. BMC Med Imaging. 2002;2(1):3.

    Article  PubMed  PubMed Central  Google Scholar 

  38. De Backer AI, Mortelé KJ, Deeren D, et al. Abdominal tuberculous lymphadenopathy: MRI features. Eur Radiol. 2005;15(10):2104–9.

    Article  CAS  PubMed  Google Scholar 

  39. Bhargava DK, Kushwaha AK, Dasarathy S, et al. Endoscopic diagnosis of segmental colonic tuberculosis. Gastrointest Endosc. 1992;38(5):571–4.

    Article  CAS  PubMed  Google Scholar 

  40. Das HS, Rathi P, Sawant P, et al. Colonic tuberculosis: colonoscopic appearance and clinico-pathologic analysis. J Assoc Physicians India. 2000;48(7):708–10.

    CAS  PubMed  Google Scholar 

  41. Alvares JF, Devarbhavi H, Makhija P, et al. Clinical, colonoscopic, and histological profile of colonic tuberculosis in a tertiary hospital. Endoscopy. 2005;37(4):351–6.

    Article  CAS  PubMed  Google Scholar 

  42. Artru P, Lavergne-Slove A, Joly F, et al. Isolated jejunal tuberculosis mimicking Crohn disease. Diagnosis by push video-enteroscopy. Gastroenterol Clin Biol. 1999;23(10):1086–9.

    CAS  PubMed  Google Scholar 

  43. Lee YJ, Yang SK, Byeon JS, et al. Analysis of colonoscopic findings in the differential diagnosis between intestinal tuberculosis and Crohn's disease. Endoscopy. 2006;38(6):592–7.

    Article  CAS  PubMed  Google Scholar 

  44. Pulimood AB, Peter S, Ramakrishna B. al. Segmental colonoscopic biopsies in the differentiation of ileocolic tuberculosis from Crohn's disease. J Gastroenterol Hepatol. 2005;20(5):688–96.

    Article  PubMed  Google Scholar 

  45. Amarapurkar DN, Patel ND, Amarapurkar AD, et al. Tissue polymerase chain reaction in diagnosis of intestinal tuberculosis and Crohn's disease. J Assoc Physicians India. 2004;52:863–7.

    CAS  PubMed  Google Scholar 

  46. Li JY, Lo ST, Ng CS, et al. Molecular detection of Mycobacterium tuberculosis in tissues showing granulomatous inflammation without demonstrable acid-fast bacilli. Diagn Mol Pathol. 2000;9(2):67–74.

    Article  CAS  PubMed  Google Scholar 

  47. Balamurugan R, Venkataraman S, John KR, et al. PCR amplification of the IS6110 insertion element of Mycobacterium tuberculosis in fecal samples from patients with intestinal tuberculosis. J Clin Microbiol. 2006;44(5):1884–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Bartu V, Havelkova M, Kopecka E. QuantiFERON-TB Gold in the diagnosis of active tuberculosis. J Int Med Res. 2008;36(3):434–7.

    Article  CAS  PubMed  Google Scholar 

  49. Pai M, Zwerling A, Menzies D. Systematic review: T-cell-based assays for the diagnosis of latent tuberculosis infection: an update. Ann Intern Med. 2008;149(3):177–84.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Epstein D, Watermeyer G, Kirsch R. Review article: the diagnosis and management of Crohn's disease in populations with high-risk rates for tuberculosis. Aliment Pharmacol Ther. 2007;25(12):1373–88.

    Article  CAS  PubMed  Google Scholar 

  51. Hinds R, Brueton MJ, Francis N, et al. Another cause of bloody diarrhoea in infancy: cytomegalovirus colitis in an immunocompetent child. J Paediatr Child Health. 2004;40(9–10):581–2.

    Article  CAS  PubMed  Google Scholar 

  52. Kandiel A, Lashner B. Cytomegalovirus colitis complicating inflammatory bowel disease. Am J Gastroenterol. 2006;101(12):2857–65.

    Article  CAS  PubMed  Google Scholar 

  53. Lawlor G, Moss AC. Cytomegalovirus in inflammatory bowel disease: pathogen of innocent bystander ? Inflamm Bowel Dis. 2010;16(9):1620–7.

    Article  PubMed  Google Scholar 

  54. Papadakis KA, Tung JK, Binder SW, et al. Outcome of cytomegalovirus infections in patients with inflammatory bowel disease. Am J Gastroenterol. 2001;96(7):2137–42.

    Article  CAS  PubMed  Google Scholar 

  55. Rahier JF, Ben-Horin S, Chowers Y, et al. European evidence-based consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease. J Crohns Colitis. 2009;3(2):47–91.

    Article  CAS  PubMed  Google Scholar 

  56. Kornbluth A, Sachar DB. Ulcerative colitis practice guidelines in adults (update): American College of Gastroenterology Practice Parameters Committee. Am J Gastroenterol. 2004;99(7):1371–85.

    Article  PubMed  Google Scholar 

  57. Rodrigues AF, Jenkins HR. Investigation and management of coeliac disease. Arch Dis Child. 2008;93(3):251–4.

    Article  CAS  PubMed  Google Scholar 

  58. Talley NJ, Shorter RG, Phillips SF, et al. Eosinophilic gastroenteritis: a clinicopathological study of patients with disease of the mucosa, muscle layer, and subserosal tissues. Gut. 1990;31(1):54–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Whitington PF, Whitington GL. Eosinophilic gastroenteropathy in childhood. J Pediatr Gastroenterol Nutr. 1988;7(3):379–85.

    Article  CAS  PubMed  Google Scholar 

  60. Kay MH, Wyllie R, Steffen RM. The endoscopic appearance of eosinophilic gastroenteritis in infancy. Am J Gastroenterol. 1995;90(8):1361–2.

    CAS  PubMed  Google Scholar 

  61. Khan S, Orenstein SR. Eosinophilic gastroenteritis: epidemiology, diagnosis and management. Best Pract Res Clin Gastroenterol. 2005;19(2):177–98.

    Article  PubMed  Google Scholar 

  62. Kalach N, Huvenne H, Gosset P, et al. Eosinophil counts in upper digestive mucosa of Western European children: variations with age, organs, symptoms, Helicobacter pylori status, and pathological findings. J Pediatr Gastroenterol Nutr. 2011;52(2):175–82.

    Article  CAS  PubMed  Google Scholar 

  63. Agarwal S, Mayer L. Gastrointestinal manifestations in primary immune disorders. Inflamm Bowel Dis. 2010;16(4):703–11.

    Article  PubMed  Google Scholar 

  64. Uhlig HH, Schwed T, Loletzko S, et al. The diagnostic approach to monogenic very early onset inflammatory bowel disease. Gastroenterology. 2014;147(5):990–1007.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Booth IW, Chrystie IL, Levinsky RJ, et al. Protracted Diarrhoea Immunodeficiency and viruses. Eur J Pediatr. 1982;138(3):271–2.

    Article  CAS  PubMed  Google Scholar 

  66. Filipovich AH, Mathur A, Kamat D, et al. Primary immunodeficiencies: genetic risk factors for lymphoma. Cancer Res. 1992;52(19 Suppl):5465s–7s.

    CAS  PubMed  Google Scholar 

  67. Washington K, Stenzel TT, Buckley RH, et al. Gastrointestinal pathology in patients with common variable immunodeficiency and X-linked agammaglobulinemia. Am J Surg Pathol. 1996;20(10):1240–52.

    Article  CAS  PubMed  Google Scholar 

  68. Teahon K, Webster AD, Price AB, et al. Studies on the enteropathy associated with primary hypogammaglobulinaemia. Gut. 1994;35(9):1244–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Bjarnason I, Sharpstone DR, Francis N, et al. Intestinal inflammation, ileal structure and function in HIV. AIDS. 1996;10(12):1385–91.

    Article  CAS  PubMed  Google Scholar 

  70. Lim SG, Condez A, Poulter LW. Mucosal macrophage subsets of the gut in HIV: decrease in antigen-presenting cell phenotype. Clin Exp Immunol. 1993;92(3):442–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Abramowsky CR, Sorensen RU. Regional enteritis-like enteropathy in a patient with agammaglobulinemia: histologic and immunocytologic studies. Hum Pathol. 1988;19(4):483–6.

    Article  CAS  PubMed  Google Scholar 

  72. Mulholland MW, Delaney JP, Simmons RL. Gastrointestinal complications of chronic granulomatous disease: surgical implications. Surgery. 1983;94(4):569–75.

    CAS  PubMed  Google Scholar 

  73. Johnson FE, Humbert JR, Kuzela DC, et al. Gastric outlet obstruction due to X-linked chronic granulomatous disease. Surgery. 1975;78(2):217–23.

    CAS  PubMed  Google Scholar 

  74. Schappi MG, Smith VV, Goldblatt D, et al. Colitis in chronic granulomatous disease. Arch Dis Child. 2001;84(2):147–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Hawkins HK, Heffelfinger SC, Anderson DC. Leukocyte adhesion deficiency: clinical and postmortem observations. Pediatr Pathol. 1992;12(1):119–30.

    Article  CAS  PubMed  Google Scholar 

  76. Hazzan D, Seward S, Stock H, et al. Crohn's-like colitis, enterocolitis and perianal disease in Hermansky-Pudlak syndrome. Colorectal Dis. 2006;8(7):539–43.

    Article  CAS  PubMed  Google Scholar 

  77. Bernstein CN, Ament M, Artinian L, et al. Crohn's ileitis in a patient with longstanding HIV infection. Am J Gastroenterol. 1994;89(6):937–9.

    CAS  PubMed  Google Scholar 

  78. Glocker EO, Kotlarz D, Boztug K, et al. Inflammatory bowel disease and mutations affecting the interleukin-10 receptor. N Engl J Med. 2009;361:2033–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  79. Kotlarz D, Beier R, Murugan D, et al. Loss of interleukin-10 signaling and infantile inflammatory bowel disease: implications for diagnosis and therapy. Gastroenterology. 2012;143:347–55.

    Article  CAS  PubMed  Google Scholar 

  80. Moran CJ, Walters TD, Guo CH, et al. IL-10R polymorphisms are associated with very-early-onset ulcerative colitis. Inflamm Bowel Dis. 2013;19:115–23.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Rigaud S, Fondaneche MC, Lambert N, et al. XIAP deficiency in humans causes an X-linked lymphoproliferative syndrome. Nature. 2006;444:110–4.

    Article  CAS  PubMed  Google Scholar 

  82. Worthey EA, Mayer AN, Syverson GD, et al. Making a definitive diagnosis: successful clinical application of whole exome sequencing in a child with intractable inflammatory bowel disease. Genet Med. 2011;13(3):255–62.

    Article  PubMed  Google Scholar 

  83. Yang X, Kanegane H, Nishida N, et al. Clinical and genetic characteristics of XIAP deficiency in Japan. J Clin Immunol. 2012;32:411–20.

    Article  CAS  PubMed  Google Scholar 

  84. Unsworth DJ, Walker-Smith JA, et al. Autoimmunity in diarrhoeal disease. J Pediatr Gastroenterol Nutr. 1985;4(3):375–80.

    Article  CAS  PubMed  Google Scholar 

  85. Montalto M, D'Onofrio F, Santoro L, et al. Autoimmune enteropathy in children and adults. Scand J Gastroenterol. 2009;44(9):1029–36.

    Article  CAS  PubMed  Google Scholar 

  86. Powell BR, Buist NR, Stenzel P. An X-linked syndrome of diarrhea, polyendocrinopathy, and fatal infection in infancy. J Pediatr. 1982;100(5):731–7.

    Article  CAS  PubMed  Google Scholar 

  87. Satake N, Nakanishi M, Okano M, et al. A Japanese family of X-linked auto-immune enteropathy with haemolytic anaemia and polyendocrinopathy. Eur J Pediatr. 1993;152(4):313–5.

    Article  CAS  PubMed  Google Scholar 

  88. Wildin RS, Smyk-Pearson S, Filipovich AH. Clinical and molecular features of the immunodysregulation, polyendocrinopathy, enteropathy, X linked (IPEX) syndrome. J Med Genet. 2002;39(8):537–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  89. Hill SM, Milla PJ, Bottazzo GF, et al. Autoimmune enteropathy and colitis: is there a generalised autoimmune gut disorder? Gut. 1991;32(1):36–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Lachaux A, Loras-Duclaux I, Bouvier R. Autoimmune enteropathy in infants. Pathological study of the disease in two familial cases. Virchows Arch. 1998;433(5):481–5.

    Article  CAS  PubMed  Google Scholar 

  91. Catassi C, Fabiani E, Spagnuolo MI, et al. Severe and protracted diarrhea: results of the 3-year SIGEP multicenter survey. Working Group of the Italian Society of Pediatric Gastroenterology and Hepatology (SIGEP). J Pediatr Gastroenterol Nutr. 1999;29(1):63–8.

    Article  CAS  PubMed  Google Scholar 

  92. Ventura A, Dragovich D. Intractable diarrhoea in infancy in the 1990s: a survey in Italy. Eur J Pediatr. 1995;154(7):522–5.

    Article  CAS  PubMed  Google Scholar 

  93. Khoo UY, Bjarnason I, Donaghy A, et al. Antibodies to colonic epithelial cells from the serum and colonic mucosal washings in ulcerative colitis. Gut. 1995;37(1):63–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  94. Ricart E, Panaccione R, Loftus EV, et al. Autoimmune disorders and extraintestinal manifestations in first-degree familial and sporadic inflammatory bowel disease: a case-control study. Inflamm Bowel Dis. 2004;10(3):207–14.

    Article  PubMed  Google Scholar 

  95. Sartoris DJ, Harell GS, Anderson MF, et al. Small-bowel lymphoma and regional enteritis: radiographic similarities. Radiology. 1984;152(2):291–6.

    Article  CAS  PubMed  Google Scholar 

  96. Isaacson PG. Gastrointestinal lymphomas of T- and B-cell types. Mod Pathol. 1999;12(2):151–8.

    CAS  PubMed  Google Scholar 

  97. Martin IG, Aldoori MI. Immunoproliferative small intestinal disease: mediterranean lymphoma and alpha heavy chain disease. Br J Surg. 1994;81(1):20–4.

    Article  CAS  PubMed  Google Scholar 

  98. Gunasekaran TS, Berman J, Gonzalez M. Duodenojejunitis: is it idiopathic or is it Henoch-Schonlein purpura without the purpura? J Pediatr Gastroenterol Nutr. 2000;30(1):22–8.

    Article  CAS  PubMed  Google Scholar 

  99. Gundogdu HZ, Kale G, Tanyel FC, et al. Intestinal perforation as an initial presentation of polyarteritis nodosa in an 8-year-old boy. J Pediatr Surg. 1993;28(4):632–4.

    Article  CAS  PubMed  Google Scholar 

  100. Brogan PA, Malik M, Shah N, et al. Systemic vasculitis: a cause of indeterminate intestinal inflammation. J Pediatr Gastroenterol Nutr. 2006;42(4):405–15.

    Article  CAS  PubMed  Google Scholar 

  101. Radhakrishnan KR, Kay M, Wyllie R, et al. Wegener granulomatosis mimicking inflammatory bowel disease in a pediatric patient. J Pediatr Gastroenterol Nutr. 2006;43(3):391–4.

    Article  PubMed  Google Scholar 

  102. Akay N, Boyvat A, Heper AO, et al. Behcet's disease-like presentation of bullous pyoderma gangrenosum associated with Crohn's disease. Clin Exp Dermatol. 2006;31(3):384–6.

    Article  CAS  PubMed  Google Scholar 

  103. Stringer DA, Cleghorn GJ, Durie PR, et al. Behcet's syndrome involving the gastrointestinal tract – a diagnostic dilemma in childhood. Pediatr Radiol. 1986;16(2):131–4.

    Article  CAS  PubMed  Google Scholar 

  104. Sultan SM, Ioannou Y, Isenberg DA. A review of gastrointestinal manifestations of systemic lupus erythematosus. Rheumatology. 1999;38(10):917–32.

    Article  CAS  PubMed  Google Scholar 

  105. Gedalia A, Cuchacovich R. Systemic vasculitis in childhood. Curr Rheumatol Rep. 2009;11(6):402–9.

    Article  PubMed  Google Scholar 

  106. Nelson J, Barron MM, Riggs JE, et al. Cerebral vasculitis and ulcerative colitis. Neurology. 1986;36(5):719–21.

    Article  CAS  PubMed  Google Scholar 

  107. Garcia-Diaz M, Mira M, Nevado L, et al. Retinal vasculitis associated with Crohn's disease. Postgrad Med J. 1995;71(833):170–2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  108. Sargent D, Sessions JT, Fairman RP. Pulmonary vasculitis complicating ulcerative colitis. South Med J. 1985;78(5):624–5.

    Article  CAS  PubMed  Google Scholar 

  109. Speiser JC, Moore TL, Zuckner J. Ulcerative colitis with arthritis and vasculitis. Clin Rheumatol. 1985;4(3):343–7.

    Article  CAS  PubMed  Google Scholar 

  110. Weizman Z. Vasculitis involving muscle associated with Crohn's colitis. Gastroenterology. 1982;82(6):1483–4.

    CAS  PubMed  Google Scholar 

  111. Saulsbury FT, Hart MH. Crohn's disease presenting with Henoch-Schonlein purpura. J Pediatr Gastroenterol Nutr. 2000;31(2):173–5.

    Article  CAS  PubMed  Google Scholar 

  112. Levine SM, Hellmann DB, Stone JH. Gastrointestinal involvement in polyarteritis nodosa (1986-2000): presentation and outcomes in 24 patients. Am J Med. 2002;112(5):386–91.

    Article  PubMed  Google Scholar 

  113. Gryboski JD, Fischer R. "Apple-core" lesion of the colon in Crohn's disease. Am J Gastroenterol. 1986;81(2):130–2.

    CAS  PubMed  Google Scholar 

  114. Martinez CR, Siegelman SS, Saba GP, et al. Localized tumor-like lesions in ulcerative colitis and Crohn's disease of the colon. Johns Hopkins Med J. 1977;140(5):249–59.

    CAS  PubMed  Google Scholar 

  115. Peterson IM, Milburn J, Reynolds M. Bowel obstruction and an apple-core lesion in an 18-year-old man. J Fam Pract. 1990;31(1):85–8.

    CAS  PubMed  Google Scholar 

  116. Griffin PM, Liff JM, Greenberg RS, et al. Adenocarcinomas of the colon and rectum in persons under 40 years old. A population-based study. Gastroenterology. 1991;100(4):1033–40.

    Article  CAS  PubMed  Google Scholar 

  117. Karnak I, Ciftci AO, Senocak ME, et al. Colorectal carcinoma in children. J Pediatr Surg. 1999;34(10):1499–504.

    Article  CAS  PubMed  Google Scholar 

  118. Salas-Valverde S, Lizano A, Gamboa Y, et al. Colon carcinoma in children and adolescents: prognostic factors and outcome-a review of 11 cases. Pediatr Surg Int. 2009;25(12):1073–6.

    Article  PubMed  Google Scholar 

  119. Chaimoff C, Dintsman M, Lurie M. Lesions mimicking malignant tumors of the large bowel. Am J Proctol Gastroenterol Colon Rectal Surg. 1981;32(6):12–26.

    PubMed  Google Scholar 

  120. Ciftci AO, Akcoren Z, Tanyel FC, et al. Inflammatory pseudotumor causing intestinal obstruction: diagnostic and therapeutic aspects. J Pediatr Surg. 1998;33(12):1843–5.

    Article  CAS  PubMed  Google Scholar 

  121. Lenaerts C, Roy CC, Vaillancourt M, et al. High incidence of upper gastrointestinal tract involvement in children with Crohn disease. Pediatrics. 1989;83(5):777–81.

    CAS  PubMed  Google Scholar 

  122. Mashako MN, Cezard JP, Navarro J, et al. Crohn's disease lesions in the upper gastrointestinal tract: correlation between clinical, radiological, endoscopic, and histological features in adolescents and children. J Pediatr Gastroenterol Nutr. 1989;8(4):442–6.

    Article  CAS  PubMed  Google Scholar 

  123. Kirschner BS, Schmidt-Sommerfeld E, Stephens JK. Gastroduodenal Crohn's disease in childhood. J Pediatr Gastroenterol Nutr. 1989;9(2):138–40.

    Article  CAS  PubMed  Google Scholar 

  124. Rutgeerts P, Onette E, Vantrappen G, et al. Crohn's disease of the stomach and duodenum: a clinical study with emphasis on the value of endoscopy and endoscopic biopsies. Endoscopy. 1980;12(6):288–94.

    Article  CAS  PubMed  Google Scholar 

  125. Grubel P, Choi Y, Schneider D, et al. Severe isolated Crohn's-like disease of the gastroduodenal tract. Dig Dis Sci. 2003;48(7):1360–5.

    Article  PubMed  Google Scholar 

  126. Danzi JT, Farmer RG, Sullivan BH, et al. Endoscopic features of gastroduodenal Crohn's disease. Gastroenterology. 1976;70(1):9–13.

    CAS  PubMed  Google Scholar 

  127. Kuriyama M, Kato J, Morimoto N, et al. Specific gastroduodenoscopic findings in Crohn's disease: comparison with findings in patients with ulcerative colitis and gastroesophageal reflux disease. Dig Liver Dis. 2008;40(6):468–75.

    Article  CAS  PubMed  Google Scholar 

  128. Markowitz J, Daum F, Aiges H, et al. Perianal disease in children and adolescents with Crohn's disease. Gastroenterology. 1984;86(5 Pt 1):829–33.

    CAS  PubMed  Google Scholar 

  129. Galbraith SS, Drolet BA, Kugathasan S, et al. Asymptomatic inflammatory bowel disease presenting with mucocutaneous findings. Pediatrics. 2005;116(3):e439–44.

    Article  PubMed  Google Scholar 

  130. Shetty AK, Udall Jr J, Schmidt-Sommerfeld E. Highly destructive perianal Crohn's disease. J Natl Med Assoc. 1998;90(8):491–2.

    CAS  PubMed  PubMed Central  Google Scholar 

  131. Markowitz J, Grancher K, Rosa J, et al. Highly destructive perianal disease in children with Crohn’s disease. J Pediatr Gastroenterol Nutr. 1995;21(2):149–53.

    Article  CAS  PubMed  Google Scholar 

  132. Porzionato A, Alaggio R, Aprile A, et al. Perianal and vulvar Crohn's disease presenting as suspected abuse. Forensic Sci Int. 2005;155(1):24–7.

    Article  PubMed  Google Scholar 

  133. Muram D. Anal and perianal abnormalities in prepubertal victims of sexual abuse. Am J Obstet Gynecol. 1989;161(2):278–81.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Thierry Lamireau MD, PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Lamireau, T., Enaud, R. (2017). Differential Diagnosis of Inflammatory Bowel Disease. In: Mamula, P., Grossman, A., Baldassano, R., Kelsen, J., Markowitz, J. (eds) Pediatric Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-49215-5_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-49215-5_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-49213-1

  • Online ISBN: 978-3-319-49215-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics