Resumo

MOSQUERA-KLINGER, Gabriel. Intestinal Tuberculosis Secondary to the Use of Biological Therapy: Can it Mimic Crohn’s Disease?. Univ. Med. [online]. 2021, vol.62, n.1, pp.110-117.  Epub 15-Jan-2021. ISSN 0041-9095.  https://doi.org/10.11144/javeriana.umed62-1.croh.

The Intestinal tuberculosis (ITB) and Crohn’s disease (CD) are chronic granulomatous disorders, that could have a transmural compromise. 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. At the end there is a discussion on the differential diagnosis between BIT and CD as these constitute a clinical challenge in the era of biological therapy.

Palavras-chave : Crohn´s disease; tuberculosis; inmunosuppression; diferential diagnostic.

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