Clinicopathological profile of gastrointestinal tuberculosis: a multinational ID-IRI study

Antonio Cascio, Affan Denk, Alpaslan Tanoglu, Tolga Yakar, Nicolas Dauby, Filiz Pehlivanoglu, Seniha Senbayrak, Recep Tekin, Fahad M. Almajid, Ahsen Oncul, Burak Ozseker, Aysegul Erdem, Meltem Tasbakan, Ahmed Ashraf Wegdan, Necati Ormeci, Soline Siméon, Secil Deniz, Fatma Amer, Sophia De Saram, Sholpan KulzhanovaMaiya Konkayeva, Zauresh Smagulova, Ozlem Aydin, Tolga Duzenli, Ozlem Aydin, Ilker Inanc Balkan, Jon S. Friedland, Sophia De Saram, Ayse Batirel, Fatma Sirmatel, Salih Cesur, Hakan Erdem, Serda Gulsun

Research output: Contribution to journalArticle

Abstract

Data are relatively scarce on gastro-intestinal tuberculosis (GITB). Most studies are old and from single centers, or did not include immunosuppressed patients. Thus, we aimed to determine the clinical, radiological, and laboratory profiles of GITB. We included adults with proven GITB treated between 2000 and 2018. Patients were enrolled from 21 referral centers in 8 countries (Belgium, Egypt, France, Italy, Kazakhstan, Saudi Arabia, UK, and Turkey). One hundred four patients were included. Terminal ileum (n = 46, 44.2%), small intestines except terminal ileum (n = 36, 34.6%), colon (n = 29, 27.8%), stomach (n = 6, 5.7%), and perianal (one patient) were the sites of GITB. One-third of all patients were immunosuppressed. Sixteen patients had diabetes, 8 had chronic renal failure, 5 were HIV positive, 4 had liver cirrhosis, and 3 had malignancies. Intestinal biopsy samples were cultured in 75 cases (78.1%) and TB was isolated in 65 patients (86.6%). PCR were performed to 37 (35.6%) biopsy samples and of these, 35 (94.6%) were positive. Ascites samples were cultured in 19 patients and M. tuberculosis was isolated in 11 (57.9%). Upper gastrointestinal endoscopy was performed to 40 patients (38.5%) and colonoscopy in 74 (71.1%). Surgical interventions were frequently the source of diagnostic samples (25 laparoscopy/20 laparotomy, n = 45, 43.3%). Patients were treated with standard and second-line anti-TB medications. Ultimately, 4 (3.8%) patients died and 2 (1.9%) cases relapsed. There was a high incidence of underlying immunosuppression in GITB patients. A high degree of clinical suspicion is necessary to initiate appropriate and timely diagnostic procedures; many patients are first diagnosed at surgery.
Original languageEnglish
Number of pages8
JournalEUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
Publication statusPublished - 2020

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Gastrointestinal Tuberculosis
Tuberculosis
Ileum
Kazakhstan
Biopsy
Gastrointestinal Endoscopy
Saudi Arabia
Egypt
Belgium

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

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Clinicopathological profile of gastrointestinal tuberculosis: a multinational ID-IRI study. / Cascio, Antonio; Denk, Affan; Tanoglu, Alpaslan; Yakar, Tolga; Dauby, Nicolas; Pehlivanoglu, Filiz; Senbayrak, Seniha; Tekin, Recep; Almajid, Fahad M.; Oncul, Ahsen; Ozseker, Burak; Erdem, Aysegul; Tasbakan, Meltem; Wegdan, Ahmed Ashraf; Ormeci, Necati; Siméon, Soline; Deniz, Secil; Amer, Fatma; De Saram, Sophia; Kulzhanova, Sholpan; Konkayeva, Maiya; Smagulova, Zauresh; Aydin, Ozlem; Duzenli, Tolga; Aydin, Ozlem; Balkan, Ilker Inanc; Friedland, Jon S.; De Saram, Sophia; Batirel, Ayse; Sirmatel, Fatma; Cesur, Salih; Erdem, Hakan; Gulsun, Serda.

In: EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2020.

Research output: Contribution to journalArticle

Cascio, A, Denk, A, Tanoglu, A, Yakar, T, Dauby, N, Pehlivanoglu, F, Senbayrak, S, Tekin, R, Almajid, FM, Oncul, A, Ozseker, B, Erdem, A, Tasbakan, M, Wegdan, AA, Ormeci, N, Siméon, S, Deniz, S, Amer, F, De Saram, S, Kulzhanova, S, Konkayeva, M, Smagulova, Z, Aydin, O, Duzenli, T, Aydin, O, Balkan, II, Friedland, JS, De Saram, S, Batirel, A, Sirmatel, F, Cesur, S, Erdem, H & Gulsun, S 2020, 'Clinicopathological profile of gastrointestinal tuberculosis: a multinational ID-IRI study', EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES.
Cascio, Antonio ; Denk, Affan ; Tanoglu, Alpaslan ; Yakar, Tolga ; Dauby, Nicolas ; Pehlivanoglu, Filiz ; Senbayrak, Seniha ; Tekin, Recep ; Almajid, Fahad M. ; Oncul, Ahsen ; Ozseker, Burak ; Erdem, Aysegul ; Tasbakan, Meltem ; Wegdan, Ahmed Ashraf ; Ormeci, Necati ; Siméon, Soline ; Deniz, Secil ; Amer, Fatma ; De Saram, Sophia ; Kulzhanova, Sholpan ; Konkayeva, Maiya ; Smagulova, Zauresh ; Aydin, Ozlem ; Duzenli, Tolga ; Aydin, Ozlem ; Balkan, Ilker Inanc ; Friedland, Jon S. ; De Saram, Sophia ; Batirel, Ayse ; Sirmatel, Fatma ; Cesur, Salih ; Erdem, Hakan ; Gulsun, Serda. / Clinicopathological profile of gastrointestinal tuberculosis: a multinational ID-IRI study. In: EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES. 2020.
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abstract = "Data are relatively scarce on gastro-intestinal tuberculosis (GITB). Most studies are old and from single centers, or did not include immunosuppressed patients. Thus, we aimed to determine the clinical, radiological, and laboratory profiles of GITB. We included adults with proven GITB treated between 2000 and 2018. Patients were enrolled from 21 referral centers in 8 countries (Belgium, Egypt, France, Italy, Kazakhstan, Saudi Arabia, UK, and Turkey). One hundred four patients were included. Terminal ileum (n = 46, 44.2{\%}), small intestines except terminal ileum (n = 36, 34.6{\%}), colon (n = 29, 27.8{\%}), stomach (n = 6, 5.7{\%}), and perianal (one patient) were the sites of GITB. One-third of all patients were immunosuppressed. Sixteen patients had diabetes, 8 had chronic renal failure, 5 were HIV positive, 4 had liver cirrhosis, and 3 had malignancies. Intestinal biopsy samples were cultured in 75 cases (78.1{\%}) and TB was isolated in 65 patients (86.6{\%}). PCR were performed to 37 (35.6{\%}) biopsy samples and of these, 35 (94.6{\%}) were positive. Ascites samples were cultured in 19 patients and M. tuberculosis was isolated in 11 (57.9{\%}). Upper gastrointestinal endoscopy was performed to 40 patients (38.5{\%}) and colonoscopy in 74 (71.1{\%}). Surgical interventions were frequently the source of diagnostic samples (25 laparoscopy/20 laparotomy, n = 45, 43.3{\%}). Patients were treated with standard and second-line anti-TB medications. Ultimately, 4 (3.8{\%}) patients died and 2 (1.9{\%}) cases relapsed. There was a high incidence of underlying immunosuppression in GITB patients. A high degree of clinical suspicion is necessary to initiate appropriate and timely diagnostic procedures; many patients are first diagnosed at surgery.",
keywords = "Endoscopy, Gastro-intestinal, Immune-suppression, Treatment, Tuberculosis",
author = "Antonio Cascio and Affan Denk and Alpaslan Tanoglu and Tolga Yakar and Nicolas Dauby and Filiz Pehlivanoglu and Seniha Senbayrak and Recep Tekin and Almajid, {Fahad M.} and Ahsen Oncul and Burak Ozseker and Aysegul Erdem and Meltem Tasbakan and Wegdan, {Ahmed Ashraf} and Necati Ormeci and Soline Sim{\'e}on and Secil Deniz and Fatma Amer and {De Saram}, Sophia and Sholpan Kulzhanova and Maiya Konkayeva and Zauresh Smagulova and Ozlem Aydin and Tolga Duzenli and Ozlem Aydin and Balkan, {Ilker Inanc} and Friedland, {Jon S.} and {De Saram}, Sophia and Ayse Batirel and Fatma Sirmatel and Salih Cesur and Hakan Erdem and Serda Gulsun",
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T1 - Clinicopathological profile of gastrointestinal tuberculosis: a multinational ID-IRI study

AU - Cascio, Antonio

AU - Denk, Affan

AU - Tanoglu, Alpaslan

AU - Yakar, Tolga

AU - Dauby, Nicolas

AU - Pehlivanoglu, Filiz

AU - Senbayrak, Seniha

AU - Tekin, Recep

AU - Almajid, Fahad M.

AU - Oncul, Ahsen

AU - Ozseker, Burak

AU - Erdem, Aysegul

AU - Tasbakan, Meltem

AU - Wegdan, Ahmed Ashraf

AU - Ormeci, Necati

AU - Siméon, Soline

AU - Deniz, Secil

AU - Amer, Fatma

AU - De Saram, Sophia

AU - Kulzhanova, Sholpan

AU - Konkayeva, Maiya

AU - Smagulova, Zauresh

AU - Aydin, Ozlem

AU - Duzenli, Tolga

AU - Aydin, Ozlem

AU - Balkan, Ilker Inanc

AU - Friedland, Jon S.

AU - De Saram, Sophia

AU - Batirel, Ayse

AU - Sirmatel, Fatma

AU - Cesur, Salih

AU - Erdem, Hakan

AU - Gulsun, Serda

PY - 2020

Y1 - 2020

N2 - Data are relatively scarce on gastro-intestinal tuberculosis (GITB). Most studies are old and from single centers, or did not include immunosuppressed patients. Thus, we aimed to determine the clinical, radiological, and laboratory profiles of GITB. We included adults with proven GITB treated between 2000 and 2018. Patients were enrolled from 21 referral centers in 8 countries (Belgium, Egypt, France, Italy, Kazakhstan, Saudi Arabia, UK, and Turkey). One hundred four patients were included. Terminal ileum (n = 46, 44.2%), small intestines except terminal ileum (n = 36, 34.6%), colon (n = 29, 27.8%), stomach (n = 6, 5.7%), and perianal (one patient) were the sites of GITB. One-third of all patients were immunosuppressed. Sixteen patients had diabetes, 8 had chronic renal failure, 5 were HIV positive, 4 had liver cirrhosis, and 3 had malignancies. Intestinal biopsy samples were cultured in 75 cases (78.1%) and TB was isolated in 65 patients (86.6%). PCR were performed to 37 (35.6%) biopsy samples and of these, 35 (94.6%) were positive. Ascites samples were cultured in 19 patients and M. tuberculosis was isolated in 11 (57.9%). Upper gastrointestinal endoscopy was performed to 40 patients (38.5%) and colonoscopy in 74 (71.1%). Surgical interventions were frequently the source of diagnostic samples (25 laparoscopy/20 laparotomy, n = 45, 43.3%). Patients were treated with standard and second-line anti-TB medications. Ultimately, 4 (3.8%) patients died and 2 (1.9%) cases relapsed. There was a high incidence of underlying immunosuppression in GITB patients. A high degree of clinical suspicion is necessary to initiate appropriate and timely diagnostic procedures; many patients are first diagnosed at surgery.

AB - Data are relatively scarce on gastro-intestinal tuberculosis (GITB). Most studies are old and from single centers, or did not include immunosuppressed patients. Thus, we aimed to determine the clinical, radiological, and laboratory profiles of GITB. We included adults with proven GITB treated between 2000 and 2018. Patients were enrolled from 21 referral centers in 8 countries (Belgium, Egypt, France, Italy, Kazakhstan, Saudi Arabia, UK, and Turkey). One hundred four patients were included. Terminal ileum (n = 46, 44.2%), small intestines except terminal ileum (n = 36, 34.6%), colon (n = 29, 27.8%), stomach (n = 6, 5.7%), and perianal (one patient) were the sites of GITB. One-third of all patients were immunosuppressed. Sixteen patients had diabetes, 8 had chronic renal failure, 5 were HIV positive, 4 had liver cirrhosis, and 3 had malignancies. Intestinal biopsy samples were cultured in 75 cases (78.1%) and TB was isolated in 65 patients (86.6%). PCR were performed to 37 (35.6%) biopsy samples and of these, 35 (94.6%) were positive. Ascites samples were cultured in 19 patients and M. tuberculosis was isolated in 11 (57.9%). Upper gastrointestinal endoscopy was performed to 40 patients (38.5%) and colonoscopy in 74 (71.1%). Surgical interventions were frequently the source of diagnostic samples (25 laparoscopy/20 laparotomy, n = 45, 43.3%). Patients were treated with standard and second-line anti-TB medications. Ultimately, 4 (3.8%) patients died and 2 (1.9%) cases relapsed. There was a high incidence of underlying immunosuppression in GITB patients. A high degree of clinical suspicion is necessary to initiate appropriate and timely diagnostic procedures; many patients are first diagnosed at surgery.

KW - Endoscopy

KW - Gastro-intestinal

KW - Immune-suppression

KW - Treatment

KW - Tuberculosis

UR - http://hdl.handle.net/10447/387341

M3 - Article

JO - EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES

JF - EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES

SN - 0934-9723

ER -