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Analysis of Phenotypic Variables and Differentiation Between Untypical Crohn’s Disease and Untypical Intestinal Tuberculosis

  • Yu Meng
  • Ying Li
  • Rong Hao
  • Xiaojun Li
  • Fanggen LuEmail author
Original Article
  • 11 Downloads

Abstract

Background

The differentiation between untypical intestinal tuberculosis (UITB) and untypical Crohn’s disease (UCD) is a challenge.

Aims

To analyze phenotypic variables and propose a novel prediction model for differential diagnosis of two conditions.

Methods

A total of 192 patients were prospectively enrolled. The clinical, laboratory, endoscopic, and radiological features were investigated and subjected to univariable and multivariable analyses. The final prediction model for differentiation between UCD and UITB was developed by logistic regression analysis and Fisher discriminant analysis on the training set. The same discriminant function was tested on the validation set.

Results

Twenty-five candidates were selected from 52 phenotypic variables of typical Crohn’s disease (TCD), UCD, and UITB patients. UCD’s variables overlapped with both TCD and UITB. The percentages of tuberculosis history, positive PPD, and positive T-SPOT result in UCD were all significantly higher than that in TCD (11.6% vs. 0.0%, 27.9% vs. 0.0%, 25.6% vs. 4.5%, respectively, P < 0.05). The regression equations and Fisher discriminant function for discrimination between UCD and UITB were developed. In the training data, the area under the receiver operating characteristic of equations was 0.834, 0.69, and 0.648 in the clinical-laboratory, endoscopic, and radiological model, respectively. The accuracy of Fisher discriminant function for discrimination was 86% in UCD and 73% in UITB in the validation data.

Conclusions

Phenotypes of UCD patients in TB-endemic countries may be associated with TB infection history. Fisher discriminant analysis is a good choice to differentiate UCD from UITB, which is worthy of verification in clinical practice.

Keywords

Untypical Crohn’s disease Intestinal tuberculosis Prediction model Fisher discriminant analysis 

Notes

Acknowledgments

The authors thank all the participants and healthcare professionals for their contributions to this study.

Funding

This study was supported by grants from the National Natural Science Foundation of China (Grant No. 81470801)

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of GastroenterologyThe Second Xiangya Hospital of Central South UniversityChangshaPeople’s Republic of China
  2. 2.Department of GastroenterologyXiangya Hospital Central South UniversityChangshaPeople’s Republic of China

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