Coagulation-related indicators serve as new and effective indicators for distinguishing Crohn's disease and intestinal tuberculosis

Coagulation-related indicators serve as new and effective indicators for distinguishing Crohn's disease and intestinal tuberculosis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Coagulation-related indicators serve as new and effective indicators for distinguishing Crohn's disease and intestinal tuberculosis Shuanghong Jiang, Yixin Li, Ting Deng, Xi Wang, Xianfei Wang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8403225/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background: Although intestinal tuberculosis (ITB) and Crohn's disease (CD) have different treatment, but their presentations are similar, therefore, distinguishing them remains a challenge for physicians. This study aimed to determine the differences between the two from the perspective of primary hospitals according to clinical characteristics. Methods: A total of 197 patients (CD 90 and ITB 107) were retrospectively enrolled from December 2013 to May 2024 in Affiliated Hospital of North Sichuan Medical College. Their characteristics, clinical features, laboratory, endoscopic, and radiographic features were recorded. SPSS 26.0 was used to perform Pearson chi-square test. Results: We found that the age of onset of CD was younger than that of ITB (p < 0.01), ITB was more likely to be combined with active pulmonary tuberculosis (p < 0.001), pleural effusion (p = 0.001) and ascites (p < 0.05). Radiologically, Compared to ITB, CD is more likely to be combined with the colonic wall thickening(p = 0.011), small bowel wall thickening(p = 0.004), and colonic and small bowel wall thickening morphology (p = 0.001). On endoscopic images, longitudinal ulcers can effectively distinguish CD (p < 0.001), and circular ulcers can distinguish ITB from CD(p = 0.002). There were statistically significant differences in clinical manifestations between the two groups, including abdominal pain, diarrhea, hematochezia, abdominal distension, fever, night sweats, cough and sputum, intestinal obstruction, and perianal abscess(p < 0.05). Interestingly, in blood tests, we found significant differences in white blood cell count, D-dimer, fibrinogen degradation products, serum albumin, and serum cancer antigen 125 ( CA125) between the two groups(p < 0.05). There were significant differences in the white blood cell (WBC)/hematocrit (HCT) ratio and platelet/activated partial thromboplastin time (APTT) ratio between the two groups(p < 0.05). Conclusion: In our cohort, many clinical features could accurately distinguish CD from ITB. Our newly discovered differences can serve as an accurate and convenient diagnostic tool to distinguish between CD and ITB, facilitating clinical decision-making. intestinal tuberculosis Crohn's disease clinical characteristics Figures Figure 1 Figure 2 Figure 3 Introduction In 2023, an estimated 10.8 million persons had incident tuberculosis(TB), Geographically, most people who developed TB in 2023 were in the WHO regions of South-East Asia (45%),Africa (24%) and the Western Pacific (17%). Most of the people who develop TB disease each year are in 30 high TB burden countries, China accounted for 6.8% of the global total in 2023[ 1 ]. Worldwide, TB is the leading cause of death from a single infectious disease agent[ 2 ]. Intestinal tuberculosis is a chronic and specific infection of the intestine caused by Mycobacterium tuberculosis invading the intestinal mucosa, which is a common extra-pulmonary TB infection[ 3 ]. Intestinal tuberculosis (ITB) is a second type of chronic intestinal disorder in China[ 4 ]. Because the clinical manifestations of intestinal tuberculosis and Crohn's(CD) disease are very similar, it is easy to be confused. Crohn’s disease is a chronic inflammatory disease of the gastrointestinal tract, with increasing incidence worldwide, the most common being the terminal ileum and colon[ 5 ]. The highest incidence rates of CD have been reported in Europe and North America, which shows a general, continent wide increase, in southern China, where the incidence rate of inflammatory bowel disease( IBD) tripled from 1.0 to 3.1 per 100,000 during the last twenty years [ 6 ]. This is particularly important since immunosuppressive treatments (anti-tumor necrosis factor, azathioprine, methotrexate and corticosteroids), smoking and malnutrition all increase the risk of TB infection in patients with CD[ 3 ]. The differential diagnosis of ITB and CD is a serious clinical problem, because incorrect diagnosis and treatment may increase morbidity and mortality[ 7 ]. Material and Methods This retrospective study enrolled patients diagnosed with Crohn's disease (CD) or intestinal tuberculosis(ITB) who received treatment at the Affiliated Hospital of North Sichuan Medical College from December 2013 to May 2024. Demographic characteristics, clinical manifestations, hematological parameters, imaging data, and endoscopic features were systematically collected. Patients with tumor, systemic lupus erythematosus, acquired immunodeficiency syndrome (AIDS), cirrhosis and pancreatitis were excluded from intestinal tuberculosis. Patients with concomitant tuberculosis, thalassemia, and cirrhosis were excluded from Crohn's disease. The final cohort included 107 ITB cases and 90 CD cases. All statistical analyses were performed using SPSS 26.0 (IBM Corp., USA). Continuous variables were non-normally distributed and are presented as median with interquartile range [M (P25, P75)]; group comparisons were conducted using the Mann-Whitney U test. Categorical variables are expressed as frequency and percentage [n (%)] and analyzed by Pearson’s chi-square test or Fisher’s exact test, as appropriate. A two-tailed p -value < 0.05 was considered statistically significant. Results Demographic Characteristics Comparative analysis of sex, age, and surgical history between the two groups revealed a statistically significant difference in age distribution ( P < 0.05). Patients with Crohn's disease (CD) demonstrated a younger age distribution compared to those with intestinal tuberculosis (ITB): 73% of CD patients were under 40 years of age, whereas only 53% of ITB patients fell within this age stratum. No statistically significant differences were observed in sex distribution or surgical history ( P > 0.05)(Table 1 .). Clinical Manifestations Patients with intestinal tuberculosis (ITB) demonstrated a statistically significant higher prevalence of abdominal distension, fever, night sweats, cough with sputum production, and intestinal obstruction compared to those with Crohn's disease (CD) ( P < 0.05). In contrast, CD patients were more frequently associated with abdominal pain, diarrhea, hematochezia, and perianal abscess formation ( P 0.05) (Table 1 .). Table 1 Demographic characteristics of ITB and CD ITB(n = 107) CD(n = 90) χ 2 value p -value Sex Male 70(65%) 58(64%) 0.02 0.886 Female 37(35%) 32(36%) onset age (years) 0–18 11(10%) 22(24%) 12.326 0.015 19–40 46(43%) 43(49%) 41–59 38(36%) 22(24%) 60–70 10(9%) 2(2%) > 70 2(2%) 1(1%) abdominal pain 70(65%) 76(84%) 9.221 0.002 diarrhea 29(27%) 51(57%) 17.715 < 0.001 hematochezia 5(5%) 34(38%) 33.741 < 0.001 abdominal distension 38(36%) 14(16%) 10.022 0.002 fever 32(30%) 16(18%) 3.902 0.048 night sweat 26(24%) 7(8%) 9.568 0.002 cough 32(30%) 1(1%) 29.066 < 0.001 abdominal mass 3(3%) 4(4%) 0.054 0.815 weight loss 57(53%) 44(49%) 0.376 0.540 decreased appetite 61(57%) 40(44%) 3.089 0.079 intestinal obstruction 37(35%) 10(11%) 14.821 < 0.001 perianal abscess 2(2%) 22(24%) 23.286 < 0.001 Appendiceal involvement 6(6%) 5(6%) < 0.001 0.987 Surgery 20(19%) 26(29%) 2.840 0.092 Anti-tuberculosis treatment 103(96%) 7(8%) 155.206 < 0.001 Hematological Parameters Statistically significant differences were observed in laboratory parameters, including FPD, albumin, CA125, WBC, and D-dimer, between the two groups ( P < 0.05). The intestinal tuberculosis (ITB) group exhibited significantly higher overall levels of FPD, CA125, and D-dimer compared to the Crohn’s disease (CD) group. Conversely, the CD group demonstrated elevated levels of albumin and WBC relative to the ITB group. No statistically significant differences were noted in C-reactive protein (CRP), erythrocyte sedimentation rate (ESR),or hemoglobin (HGB) levels ( P > 0.05). Statistically significant differences were observed in WBC/HCT and platelet/aPTT ratios between the two groups ( P < 0.05). The Crohn’s disease (CD) group exhibited a higher mean WBC/HCT ratio (22.75) compared to the intestinal tuberculosis (ITB) group (19.61), along with a higher mean platelet/aPTT ratio (9.17 vs. 7.71). No statistically significant differences were noted in other laboratory parameters ( P > 0.05). (Table 2 ) Table 2 Hematological Parameters characteristics of ITB and CD ITB CD Z value p-value CRP(mg/L,0–8) 34.69(15.28,84.45) 44.52(18.84,71.32) -0.044 0.965 ESR(mm/h,0–26) 39.50(20.25,65.25) 46(19,70.50) -0.620 0.535 WBC(10 9 /L) 6.30(4.94,8.80) 7.78(5.96,10.52) -2.630 0.009 HGB(g/L) 108(88,123.75) 104.5(87,128) -0.054 0.957 HCT(L/L0.35-0.45) 0.34(0.28,0.39) 0.33(0.29,0.39) -0.035 0.972 Lymphocyte(20–50) % 16.1(9.4,21.2) 16.5(12,22.1) -1.103 0.270 Platelet(10 9 /L) 321.5(230.5,461.0) 358(258.25,445.50) -0.827 0.408 D-Dimer(µg/mL,0–1) 3.09(2.09,5.26) 1.16(0.70,1.98) -3.505 < 0.001 APTT(s,24–39) 38.95(35.60,46.33) 37.95(34.30,42.00) -1.843 0.065 FIB(g/L,2–4) 4.61(3.66,5.55) 5.07(3.84,5.96) -1.314 0.189 P-FDP(ug/ml,0–5) 6.19(3.18,14.83) 3.2(2.56,4.65) -4.680 < 0.001 ALB (g/L,40–55) 33.80(28.38,39.13) 37.75(33.25,42.38) -3.145 0.002 CA125(U/ml,0–35) 154.85(43.82,283.58) 18.31(12.20,34.58) -2.694 0.007 CA199(U/m,l0-37) 13.74(2.64,19.17) 7.71(3.28,13.06) -1.149 0.251 WBC/Lymphocyte 0.40(0.25,0.87) 0.46(0.28,0.84) -0.682 0.495 WBC/Platelet 0.021(0.014,0.029) 0.023(0.017,0.031) -1.169 0.204 WBC/HCT 19.61(13.70,28.26) 22.75(17.23,33.83) -2.187 0.029 WBC/APTT 0.16(0.12,0.23) 0.15(0.13,0.21) -0.225 0.822 Platelet/HCT 1014.54(598.34,1391.70) 1082.38(656.00,1508.97) -0.762 0.446 Platelet/APTT 7.71(5.52,11.25) 9.17(6.89,11.53) -2.459 0.014 Lymphocyte/Platelet 0.21(0.14,0.29) 0.23(0.18,0.32) -1.269 0.204 ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; WBC, white blood cell ; HGB, hemoglobin; HCT, hematocri; APTT, partial thromboplastin time; FIB, plasma fibrinogen concentration; P-FDP, fibrinogen degradation products; ALB, serum albumin; CA125, Cancer antigen 125; CA199, Cancer antigen 199; Imaging Findings Chest imaging shows that TB is more likely to develop pleural effusion (TB(27.9%); CD(7.6%); p = 0.001) and active pulmonary tuberculosis(TB(71.2%);CD(2.5%); P < 0.001), while there is no difference in the incidence of old pulmonary tuberculosis between TB(1.9%) and CD(1.3%)( p = 1.000). Abdominal computed X-ray tomography(CT) analyses revealed statistically significant intergroup differences in colonic wall thickening, small bowel wall thickening, ascites, and colonic and small bowel wall thickening morphology (P < 0.05). Notably, ascites were more frequently observed in the ITB group compared to the CD group, while the CD group exhibited higher rates of colonic wall thickening, small bowel wall thickening and combined colonic + small bowel wall thickening. No statistically significant differences were identified in Abdominal lymphadenopathy, luminal stenosis (P ≥ 0.05). Endoscopic Characteristics Endoscopic evaluation revealed statistically significant differences between the two groups in the prevalence of longitudinal ulcers, circular ulcers and colonic ulcers ( p < 0.05). Patients in the Crohn’s disease (CD) group demonstrated a significantly higher proportion of longitudinal ulcers(31%) and colonic ulcers(67%) compared to those in the intestinal tuberculosis (ITB) group(respectively 0%, 36%). The proportion of circular ulcers in intestinal tuberculosis(25%) is higher compared to Crohn's disease(2%). No statistically significant differences were observed in the presentation of terminal ileum/ileocecal ulcers, terminal ileum/ileocecal erosion or colonic stenosis ( p > 0.05). Under endoscopy, intestinal tuberculosis often presents as circular ulcer, irregular ulcers, erosion, inflammatory polypoid changes, scars, tumor like edema with redness and intestinal stenosis(Fig. 1 and Fig. 3 ). Crohn's disease often presents as longitudinal ulcer, punctate erosions, thrush like ulcer, irregular ulcer, inflammatory polyp like, redness, edema, tumor like with intestinal stenosis(Fig. 2 and Fig. 3 ). Discussion Crohn's disease is a chronic inflammatory bowel disease (IBD), and the pathogenesis of CD is caused by a complex interactions of genetic susceptibility to host and environmental factors, intestinal dysbiosis, and dysregulated immune responses[ 7 ], while ITB is caused by intestinal mycobacteria. ITB causes chronic intestinal inflammation, easily confused with CD[ 8 ]. In TB endemic countries[ 4 ] and where CD incidence rate is increasing[ 9 ], particular attention should be paid. Sometimes clinical and radiological features of ITB and CT are nonspecific[ 10 ], it is very importance to differentiate between the two otherwise very similar conditions[ 11 ]. We found that CD patients trended younger than ITB patients, consistent with Julajak Limsrivili's study[ 12 ]. Diarrhea, hematochezia, perianal abscess significantly favored CD[ 13 ], whereas fever, night sweats, cough, active pulmonary tuberculosis, pleural effusion, and ascites significantly favored ITB. The same conclusion was reached in a study of 2117 CD and 1589 ITB patients in Julajak Limsrivili's study[ 12 ]. We found that CD is more prone to abdominal pain, while some studies suggest no difference between the two[ 7 , 12 , 14 ]. Our study also found that ITB is more prone to abdominal distension and intestinal obstruction, Some studies suggest that it is not possible to distinguish between the two[ 7 , 12 , 14 ]. In our imaging data, we found no difference in intestinal stenosis between the two. Interestingly, we found that CD is more prone to colon wall thickening and small intestine wall thickening, consistent with this study in China[ 15 ] and Esther Merino Gallego's review[ 3 ]. Some studies also suggest that there is no difference[ 7 ]. Our research found that CD is more likely to cause colon ulcers and longitudinal ulcers, consistent with many studies[ 3 , 7 , 14 , 16 , 17 ]. Regarding the positive rate of longitudinal ulcers, Makharia et al. [ 18 ]reported that 30.1% of Crohn's disease patients and 7.5% of intestinal tuberculosis patients had longitudinal ulcers. We found an advantage of circular ulcers in ITB. Li et al[ 19 ] reported that 41.0% of patents with intestinal tuberculosis and 4.6% of patients with Crohn's disease had circular ulcers. Favresse , s [ 20 ]study found that 43.2% of ITBs had abdominal lymph node enlargement, while our study found that 27% of ITBs had lymph node enlargement, but there was no difference between the ITB and CD groups. We found that 36% of ITBs have colon ulcers, with the majority of ulcers occurring in the ileocecal region, consistent with previous studies[ 20 ]. Our results are consistent with Huang [ 21 ], and PLT is meaningless in distinguishing between active CD and ITB. We found that compared to ITB in the CD group, the white blood cell count and serum albumin concentration were higher. CA125 has been found to be associated with ascites in other studies[ 22 ], in this study we found that CA125 was significantly elevated in the ITB group, was consistent with our study that ITB is more prone to ascites and pleural effusion. D-dimer and P-FDP is a soluble fibrin degradation product deriving from the plasmin-mediated degradation of cross-linked fibrin, for diagnosing disseminated intravascular coagulation, and for screening medical patients at increased risk of VTE ( venous thromboembolism ). D-dimer and P-FDP can hence be considered a biomarker of activation of coagulation and fibrinolysis[ 23 ]. In the detection of coagulation function, we found that D-dimer and P-FDP were significantly elevated in ITB patients, which can effectively distinguish CD from ITB. This indicates that ITB patients have coagulation abnormalities. WBC/HCT ratio and Platelet/APTT ratio was increased in CD. Conclusion In summary, misdiagnosis often occurs in the diagnosis of intestinal tuberculosis and Crohn's disease. Therefore, clinical doctors should comprehensively analyze the clinical manifestations, endoscopy, imaging findings, blood test indicators, etc. of intestinal tuberculosis and Crohn's disease in order to further improve the accuracy of diagnosis. D-Dimer and P-FDP may become a convenient indicator for distinguishing CD from ITB. Abbreviations IBD: inflammatory bowel disease ; ITB:intestinal tuberculosis;CD: Crohn's disease ;ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; WBC, white blood cell ; HGB, hemoglobin; HCT, hematocri; APTT, partial thromboplastin time; FIB, plasma fibrinogen concentration; P-FDP, fibrinogen degradation products; ALB, serum albumin; CA125, Cancer antigen 125; CA199, Cancer antigen 199; Declarations Ethics approval and consent to participate The article was published with the approval of the Affiliated Hospital of North Sichuan Medical College ethics committee(protocol code 2024ER143-1). Consent for publication We did not obtain informed consent from all participants.It was waived by an Institutional Review Board (IRB)(the Affiliated Hospital of North Sichuan Medical College ) Availability of Data and Materials : The Ungdata surveys that support the findings of this study are available from Norwegian Social Research (NOVA), but restrictions apply to the availability of these data, which were used under licence for the current study and so are not publicly available. The data are, however, available upon request and with the permission of Norwegian Social Research (NOVA). Competing Interests The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Funding This work was supported by the 2025 Nanchong Social Science Research 14th Five Year Plan Project(grant number:NC25B256). 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8403225","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":618341015,"identity":"22e26370-e8c9-47bf-a2ee-a391d2d6b09a","order_by":0,"name":"Shuanghong Jiang","email":"","orcid":"","institution":"Digestive Endoscopy Center, Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College.","correspondingAuthor":false,"prefix":"","firstName":"Shuanghong","middleName":"","lastName":"Jiang","suffix":""},{"id":618341025,"identity":"fa1aff55-d89c-4358-a254-8fcb2fec6348","order_by":1,"name":"Yixin Li","email":"","orcid":"","institution":"School of clinical medicine, North Sichuan Medical College.","correspondingAuthor":false,"prefix":"","firstName":"Yixin","middleName":"","lastName":"Li","suffix":""},{"id":618341029,"identity":"0e8fbe7f-d606-4c8b-81ba-656510dab457","order_by":2,"name":"Ting Deng","email":"","orcid":"","institution":"School of clinical medicine, North Sichuan Medical College.","correspondingAuthor":false,"prefix":"","firstName":"Ting","middleName":"","lastName":"Deng","suffix":""},{"id":618341031,"identity":"a49dd0e9-d05d-4fb3-89c5-9b353fe8142c","order_by":3,"name":"Xi Wang","email":"","orcid":"","institution":"Digestive Endoscopy Center, Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College.","correspondingAuthor":false,"prefix":"","firstName":"Xi","middleName":"","lastName":"Wang","suffix":""},{"id":618341032,"identity":"053ed23a-99a0-4534-a9a6-a75669423228","order_by":4,"name":"Xianfei Wang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyElEQVRIiWNgGAWjYBACfmb+DwYffrDJsbE3EKlFsp3BoHBmD58xH88BIrUY9DMYfOZhk0ucJ5FArBZmhsTNPDxmiW2SjzfeYKixiSaoxZyZ4bDhHIs04zbptGILhmNpuQ2EtFg2M7YZvOE5JtsmnWMmwdhwmLAWg8PM7D942P4ztkmeIVoLG4MhDxubYpsED5FaJJt5GAxn9rAZs/EA/ZJAjF/4+c8wgKNSvv3wxhsfamwIa0FxJNFRg6SFVB2jYBSMglEwMgAAw8Y5JqBfafwAAAAASUVORK5CYII=","orcid":"","institution":"Digestive Endoscopy Center, Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College.","correspondingAuthor":true,"prefix":"","firstName":"Xianfei","middleName":"","lastName":"Wang","suffix":""}],"badges":[],"createdAt":"2025-12-19 09:53:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8403225/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8403225/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106535171,"identity":"d4078bed-68ac-4542-a56a-57ae7e53dba2","added_by":"auto","created_at":"2026-04-09 15:08:02","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":945791,"visible":true,"origin":"","legend":"\u003cp\u003eColonoscopy images of intestinal tuberculosis. Circular ulcer (C.F.G.I), irregular ulcers(B.D.E), inflammatory polypoid changes(A.H), scars(A), tumor like edema with redness and intestinal stenosis(J).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8403225/v1/65e238481dae233cba144861.png"},{"id":106535169,"identity":"b46ca301-99a9-4f91-ae9a-76305c9c4f24","added_by":"auto","created_at":"2026-04-09 15:08:02","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":930972,"visible":true,"origin":"","legend":"\u003cp\u003eColonoscopy images of Crohn's disease. Longitudinal ulcer(F), punctate thrush like ulcer(C.D.E), irregular ulcer(A.B.G), inflammatory polyp like(H), red and swollen(I), tumor like with intestinal stenosis(J).\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8403225/v1/ff38919d4ae3def97b724ffe.png"},{"id":106535174,"identity":"10f5fc00-8fc1-462a-b580-65b1456e73a5","added_by":"auto","created_at":"2026-04-09 15:08:02","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":1074581,"visible":true,"origin":"","legend":"\u003cp\u003eEnd ileum colonoscopy image. The manifestations of intestinal tuberculosis in the terminal ileum mucosa include erosion(A), semi-circular ulcers, and edema(B.C). The manifestations of Crohn's disease in the terminal ileum mucosa include punctate erosions(D), redness, edema(E.H), irregular ulcers(F), and longitudinal ulcers(G).\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-8403225/v1/25dc5bdac725ece289e8a012.png"},{"id":107704864,"identity":"48bdc0ec-3b92-4686-834a-73cf83723126","added_by":"auto","created_at":"2026-04-24 09:01:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4770301,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8403225/v1/3bb81a0b-8a85-4c60-869c-53806fb3885d.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Coagulation-related indicators serve as new and effective indicators for distinguishing Crohn's disease and intestinal tuberculosis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn 2023, an estimated 10.8\u0026nbsp;million persons had incident tuberculosis(TB), Geographically, most people who developed TB in 2023 were in the WHO regions of South-East Asia (45%),Africa (24%) and the Western Pacific (17%). Most of the people who develop TB disease each year are in 30 high TB burden countries, China accounted for 6.8% of the global total in 2023[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Worldwide, TB is the leading cause of death from a single infectious disease agent[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Intestinal tuberculosis is a chronic and specific infection of the intestine caused by Mycobacterium tuberculosis invading the intestinal mucosa, which is a common extra-pulmonary TB infection[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Intestinal tuberculosis (ITB) is a second type of chronic intestinal disorder in China[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Because the clinical manifestations of intestinal tuberculosis and Crohn's(CD) disease are very similar, it is easy to be confused. Crohn\u0026rsquo;s disease is a chronic inflammatory disease of the gastrointestinal tract, with increasing incidence worldwide, the most common being the terminal ileum and colon[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The highest incidence rates of CD have been reported in Europe and North America, which shows a general, continent wide increase, in southern China, where the incidence rate of inflammatory bowel disease( IBD) tripled from 1.0 to 3.1 per 100,000 during the last twenty years [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. This is particularly important since immunosuppressive treatments (anti-tumor necrosis factor, azathioprine, methotrexate and corticosteroids), smoking and malnutrition all increase the risk of TB infection in patients with CD[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The differential diagnosis of ITB and CD is a serious clinical problem, because incorrect diagnosis and treatment may increase morbidity and mortality[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e"},{"header":"Material and Methods","content":"\u003cp\u003eThis retrospective study enrolled patients diagnosed with Crohn's disease (CD) or intestinal tuberculosis(ITB) who received treatment at the Affiliated Hospital of North Sichuan Medical College from December 2013 to May 2024. Demographic characteristics, clinical manifestations, hematological parameters, imaging data, and endoscopic features were systematically collected. Patients with tumor, systemic lupus erythematosus, acquired immunodeficiency syndrome (AIDS), cirrhosis and pancreatitis were excluded from intestinal tuberculosis. Patients with concomitant tuberculosis, thalassemia, and cirrhosis were excluded from Crohn's disease. The final cohort included 107 ITB cases and 90 CD cases.\u003c/p\u003e \u003cp\u003eAll statistical analyses were performed using SPSS 26.0 (IBM Corp., USA). Continuous variables were non-normally distributed and are presented as median with interquartile range [M (P25, P75)]; group comparisons were conducted using the Mann-Whitney U test. Categorical variables are expressed as frequency and percentage [n (%)] and analyzed by Pearson\u0026rsquo;s chi-square test or Fisher\u0026rsquo;s exact test, as appropriate. A two-tailed \u003cem\u003ep\u003c/em\u003e-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eDemographic Characteristics\u003c/h2\u003e \u003cp\u003eComparative analysis of sex, age, and surgical history between the two groups revealed a statistically significant difference in age distribution (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Patients with Crohn's disease (CD) demonstrated a younger age distribution compared to those with intestinal tuberculosis (ITB): 73% of CD patients were under 40 years of age, whereas only 53% of ITB patients fell within this age stratum. No statistically significant differences were observed in sex distribution or surgical history (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05)(Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eClinical Manifestations\u003c/h3\u003e\n\u003cp\u003ePatients with intestinal tuberculosis (ITB) demonstrated a statistically significant higher prevalence of abdominal distension, fever, night sweats, cough with sputum production, and intestinal obstruction compared to those with Crohn's disease (CD) (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). In contrast, CD patients were more frequently associated with abdominal pain, diarrhea, hematochezia, and perianal abscess formation (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eNo statistically significant differences were observed between the two groups regarding the incidence of abdominal mass, weight loss, decreased appetite, orappendiceal involvement (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics of ITB and CD\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eITB(n\u0026thinsp;=\u0026thinsp;107)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCD(n\u0026thinsp;=\u0026thinsp;90)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70(65%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58(64%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.886\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37(35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32(36%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eonset\u0026nbsp;age (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;18\u003c/p\u003e \u003c/td\u003e 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\u003cp\u003e38(36%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22(24%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60\u0026ndash;70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10(9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eabdominal pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70(65%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76(84%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ediarrhea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29(27%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51(57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.715\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ehematochezia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5(5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34(38%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.741\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eabdominal distension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38(36%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14(16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003efever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32(30%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.902\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.048\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enight sweat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26(24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.568\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ecough\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32(30%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eabdominal mass\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.815\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eweight loss\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57(53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44(49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.376\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.540\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edecreased appetite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61(57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40(44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.089\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.079\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eintestinal obstruction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37(35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.821\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eperianal abscess\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22(24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAppendiceal involvement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6(6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.987\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSurgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20(19%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.840\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.092\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnti-tuberculosis treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e103(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e155.206\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eHematological Parameters\u003c/h3\u003e\n\u003cp\u003eStatistically significant differences were observed in laboratory parameters, including FPD, albumin, CA125, WBC, and D-dimer, between the two groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The intestinal tuberculosis (ITB) group exhibited significantly higher overall levels of FPD, CA125, and D-dimer compared to the Crohn\u0026rsquo;s disease (CD) group. Conversely, the CD group demonstrated elevated levels of albumin and WBC relative to the ITB group. No statistically significant differences were noted in C-reactive protein (CRP), erythrocyte sedimentation rate (ESR),or hemoglobin (HGB) levels (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eStatistically significant differences were observed in WBC/HCT and platelet/aPTT ratios between the two groups (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The Crohn\u0026rsquo;s disease (CD) group exhibited a higher mean WBC/HCT ratio (22.75) compared to the intestinal tuberculosis (ITB) group (19.61), along with a higher mean platelet/aPTT ratio (9.17 vs. 7.71). No statistically significant differences were noted in other laboratory parameters (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHematological Parameters characteristics of ITB and CD\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eITB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eZ value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRP(mg/L,0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34.69(15.28,84.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44.52(18.84,71.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.044\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.965\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eESR(mm/h,0\u0026ndash;26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e39.50(20.25,65.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46(19,70.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.620\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.535\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC(10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.30(4.94,8.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.78(5.96,10.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-2.630\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHGB(g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e108(88,123.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e104.5(87,128)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.957\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHCT(L/L0.35-0.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.34(0.28,0.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.33(0.29,0.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.972\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphocyte(20\u0026ndash;50) %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16.1(9.4,21.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.5(12,22.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.270\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlatelet(10\u003csup\u003e9\u003c/sup\u003e/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e321.5(230.5,461.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e358(258.25,445.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.827\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.408\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eD-Dimer(\u0026micro;g/mL,0\u0026ndash;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.09(2.09,5.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.16(0.70,1.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-3.505\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAPTT(s,24\u0026ndash;39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38.95(35.60,46.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37.95(34.30,42.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.843\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFIB(g/L,2\u0026ndash;4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.61(3.66,5.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.07(3.84,5.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.314\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.189\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP-FDP(ug/ml,0\u0026ndash;5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.19(3.18,14.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.2(2.56,4.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-4.680\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eALB\u0026nbsp;(g/L,40\u0026ndash;55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33.80(28.38,39.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37.75(33.25,42.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-3.145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCA125(U/ml,0\u0026ndash;35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e154.85(43.82,283.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.31(12.20,34.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-2.694\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCA199(U/m,l0-37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13.74(2.64,19.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.71(3.28,13.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.251\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC/Lymphocyte\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.40(0.25,0.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.46(0.28,0.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.682\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.495\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC/Platelet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.021(0.014,0.029)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.023(0.017,0.031)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.204\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC/HCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19.61(13.70,28.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.75(17.23,33.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-2.187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC/APTT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.16(0.12,0.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.15(0.13,0.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.822\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlatelet/HCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1014.54(598.34,1391.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1082.38(656.00,1508.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.762\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.446\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlatelet/APTT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.71(5.52,11.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.17(6.89,11.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-2.459\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphocyte/Platelet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.21(0.14,0.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.23(0.18,0.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.204\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eESR, erythrocyte sedimentation rate; CRP, C-reactive protein; WBC, white blood cell ; HGB, hemoglobin; HCT, hematocri; APTT, partial thromboplastin time; FIB, plasma fibrinogen concentration; P-FDP, fibrinogen degradation products; ALB, serum albumin; CA125, Cancer antigen 125; CA199, Cancer antigen 199;\u003c/p\u003e\n\u003ch3\u003eImaging Findings\u003c/h3\u003e\n\u003cp\u003eChest imaging shows that TB is more likely to develop pleural effusion (TB(27.9%); CD(7.6%); \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001) and active pulmonary tuberculosis(TB(71.2%);CD(2.5%); P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while there is no difference in the incidence of old pulmonary tuberculosis between TB(1.9%) and CD(1.3%)(\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.000). Abdominal computed X-ray tomography(CT) analyses revealed statistically significant intergroup differences in colonic wall thickening, small bowel wall thickening, ascites, and colonic and small bowel wall thickening morphology (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Notably, ascites were more frequently observed in the ITB group compared to the CD group, while the CD group exhibited higher rates of colonic wall thickening, small bowel wall thickening and combined colonic\u0026thinsp;+\u0026thinsp;small bowel wall thickening. No statistically significant differences were identified in Abdominal lymphadenopathy, luminal stenosis (P\u0026thinsp;\u0026ge;\u0026thinsp;0.05).\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eEndoscopic Characteristics\u003c/h2\u003e \u003cp\u003eEndoscopic evaluation revealed statistically significant differences between the two groups in the prevalence of longitudinal ulcers, circular ulcers and colonic ulcers (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Patients in the Crohn\u0026rsquo;s disease (CD) group demonstrated a significantly higher proportion of longitudinal ulcers(31%) and colonic ulcers(67%) compared to those in the intestinal tuberculosis (ITB) group(respectively 0%, 36%). The proportion of circular ulcers in intestinal tuberculosis(25%) is higher compared to Crohn's disease(2%). No statistically significant differences were observed in the presentation of terminal ileum/ileocecal ulcers, terminal ileum/ileocecal erosion or colonic stenosis (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eUnder endoscopy, intestinal tuberculosis often presents as circular ulcer, irregular ulcers, erosion, inflammatory polypoid changes, scars, tumor like edema with redness and intestinal stenosis(Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Crohn's disease often presents as longitudinal ulcer, punctate erosions, thrush like ulcer, irregular ulcer, inflammatory polyp like, redness, edema, tumor like with intestinal stenosis(Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eCrohn's disease is a chronic inflammatory bowel disease (IBD), and the pathogenesis of CD is caused by a complex interactions of genetic susceptibility to host and environmental factors, intestinal dysbiosis, and dysregulated immune responses[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], while ITB is caused by intestinal mycobacteria. ITB causes chronic intestinal inflammation, easily confused with CD[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. In TB endemic countries[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] and where CD incidence rate is increasing[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], particular attention should be paid. Sometimes clinical and radiological features of ITB and CT are nonspecific[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], it is very importance to differentiate between the two otherwise very similar conditions[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWe found that CD patients trended younger than ITB patients, consistent with Julajak Limsrivili's study[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Diarrhea, hematochezia, perianal abscess significantly favored CD[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], whereas fever, night sweats, cough, active pulmonary tuberculosis, pleural effusion, and ascites significantly favored ITB. The same conclusion was reached in a study of 2117 CD and 1589 ITB patients in Julajak Limsrivili's study[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. We found that CD is more prone to abdominal pain, while some studies suggest no difference between the two[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Our study also found that ITB is more prone to abdominal distension and intestinal obstruction, Some studies suggest that it is not possible to distinguish between the two[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In our imaging data, we found no difference in intestinal stenosis between the two. Interestingly, we found that CD is more prone to colon wall thickening and small intestine wall thickening, consistent with this study in China[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] and Esther Merino Gallego's review[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Some studies also suggest that there is no difference[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Our research found that CD is more likely to cause colon ulcers and longitudinal ulcers, consistent with many studies[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Regarding the positive rate of longitudinal ulcers, Makharia et al. [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]reported that 30.1% of Crohn's disease patients and 7.5% of intestinal tuberculosis patients had longitudinal ulcers. We found an advantage of circular ulcers in ITB. Li et al[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] reported that 41.0% of patents with intestinal tuberculosis and 4.6% of patients with Crohn's disease had circular ulcers. Favresse\u003csup\u003e,\u003c/sup\u003es [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]study found that 43.2% of ITBs had abdominal lymph node enlargement, while our study found that 27% of ITBs had lymph node enlargement, but there was no difference between the ITB and CD groups. We found that 36% of ITBs have colon ulcers, with the majority of ulcers occurring in the ileocecal region, consistent with previous studies[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOur results are consistent with Huang [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], and PLT is meaningless in distinguishing between active CD and ITB. We found that compared to ITB in the CD group, the white blood cell count and serum albumin concentration were higher. CA125 has been found to be associated with ascites in other studies[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], in this study we found that CA125 was significantly elevated in the ITB group, was consistent with our study that ITB is more prone to ascites and pleural effusion.\u003c/p\u003e \u003cp\u003eD-dimer and P-FDP is a soluble fibrin degradation product deriving from the plasmin-mediated degradation of cross-linked fibrin, for diagnosing disseminated intravascular coagulation, and for screening medical patients at increased risk of VTE ( venous thromboembolism ). D-dimer and P-FDP can hence be considered a biomarker of activation of coagulation and fibrinolysis[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. In the detection of coagulation function, we found that D-dimer and P-FDP were significantly elevated in ITB patients, which can effectively distinguish CD from ITB. This indicates that ITB patients have coagulation abnormalities. WBC/HCT ratio and Platelet/APTT ratio was increased in CD.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn summary, misdiagnosis often occurs in the diagnosis of intestinal tuberculosis and Crohn's disease. Therefore, clinical doctors should comprehensively analyze the clinical manifestations, endoscopy, imaging findings, blood test indicators, etc. of intestinal tuberculosis and Crohn's disease in order to further improve the accuracy of diagnosis. D-Dimer and P-FDP may become a convenient indicator for distinguishing CD from ITB.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003cp\u003eIBD: inflammatory bowel disease ; ITB:intestinal tuberculosis;CD: Crohn\u0026apos;s disease ;ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; WBC, white blood cell ; HGB, hemoglobin; HCT, hematocri; APTT, partial thromboplastin time; FIB, plasma fibrinogen concentration; P-FDP, fibrinogen degradation products; ALB, serum albumin; CA125, Cancer antigen 125; CA199, Cancer antigen 199;\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics\u0026nbsp;approval\u0026nbsp;and\u0026nbsp;consent\u0026nbsp;to\u0026nbsp;participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe article was published with the approval of the\u0026nbsp;Affiliated Hospital of North Sichuan Medical College\u0026nbsp;ethics committee(protocol code 2024ER143-1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe did not obtain informed consent from all participants.It was waived by an Institutional Review Board (IRB)(the\u0026nbsp;Affiliated Hospital of North Sichuan Medical College\u0026nbsp;)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials :\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Ungdata surveys that support the findings of this study are available from Norwegian Social Research (NOVA), but restrictions apply to the availability of these data, which were used under licence for the current study and so are not publicly available. The data are, however, available upon request and with the permission of Norwegian Social Research (NOVA).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by the 2025 Nanchong Social Science Research 14th Five Year Plan Project(grant number:NC25B256).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSH Jiang , XF Wang: Research design and manuscript revision. YX Li , T Deng ,X Wang: Data collection and analysis, and drafting of the article. All authors read and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. Global tuberculosis report 2024. In:2024; \u003cem\u003eGeneva: World Health Organization; 2024\u003c/em\u003e; 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMacNeil A, Glaziou P, Sismanidis C, Date A, Maloney S, Floyd K. Global Epidemiology of Tuberculosis and Progress Toward Meeting Global Targets - Worldwide, 2018. MMWR-MORBID MORTAL W. 2020;69(11):281\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMerino GE, Gallardo SF, Gallego RF. Intestinal tuberculosis and Crohn's disease: the importance and difficulty of a differential diagnosis. REV ESP ENFERM DIG. 2018;110(10):650\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJiang M, Zeng Z, Chen K, Dang Y, Li L, Ma C, Cheng R, Hu K, Li X, Zhang H. Enterogenous Microbiotic Markers in the Differential Diagnosis of Crohn's Disease and Intestinal Tuberculosis. FRONT IMMUNOL. 2022;13:820891.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTorres J, Mehandru S, Colombel JF, Peyrin-Biroulet L. Crohn's disease. Lancet. 2017;389(10080):1741\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMak WY, Zhao M, Ng SC, Burisch J. The epidemiology of inflammatory bowel disease: East meets west. J GASTROEN HEPATOL. 2020;35(3):380\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChoudhury A, Dhillon J, Sekar A, Gupta P, Singh H, Sharma V. Differentiating gastrointestinal tuberculosis and Crohn's disease- a comprehensive review. BMC GASTROENTEROL. 2023;23(1):246.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCastellotti P, Riccardi N, Ferrarese M, Canetti D, Fanti D, Forti E, Reda M, Alexiadis S, Bonoldi E, Saporiti M, et al. Intestinal tuberculosis versus Inflammatory Bowel Diseases: a never-ending challenge. NEW MICROBIOL. 2020;43(3):139\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAswani-Omprakash T, Sharma V, Bishu S, Balasubramaniam M, Bhatia S, Nandi N, Shah ND, Deepak P, Sebastian S. Addressing unmet needs from a new frontier of IBD: the South Asian IBD Alliance. LANCET GASTROENTEROL. 2021;6(11):884\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGharbi G, Mahmoudi M, Yakoubi M, Mohamed AB, Khsiba A, M'Farrej MK, Bouassida M, Chelbi E, Hamzaoui L. Colonic tuberculosis: a case report. FUTUR SCI OA. 2022;8(10):FSO830.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWeinberg SE, Mughal AM. A Case of Intestinal Tuberculosis Mimicking Crohn's Disease: A Clinical and Diagnostic Dilemma. Eur J Case Rep Intern Med. 2021;8(11):2699.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLimsrivilai J, Shreiner AB, Pongpaibul A, Laohapand C, Boonanuwat R, Pausawasdi N, Pongprasobchai S, Manatsathit S, Higgins PD. Meta-Analytic Bayesian Model For Differentiating Intestinal Tuberculosis from Crohn's Disease. AM J GASTROENTEROL. 2017;112(3):415\u0026ndash;27.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQari YA. Clinical Characteristics of Crohn's Disease in a Cohort from Saudi Arabia. SAUDI J MED MED SCI. 2022;10(1):56\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZeng S, Lin Y, Guo J, Chen X, Liang Q, Zhai X, Tao J. Differential diagnosis of Crohn's disease and intestinal tuberculosis: development and assessment of a nomogram prediction model. 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WORLD J GASTROENTERO. 2015;21(12):3650\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMakharia GK, Srivastava S, Das P, Goswami P, Singh U, Tripathi M, Deo V, Aggarwal A, Tiwari RP, Sreenivas V, et al. Clinical, endoscopic, and histological differentiations between Crohn's disease and intestinal tuberculosis. AM J GASTROENTEROL. 2010;105(3):642\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi X, Liu X, Zou Y, Ouyang C, Wu X, Zhou M, Chen L, Ye L, Lu F. Predictors of clinical and endoscopic findings in differentiating Crohn's disease from intestinal tuberculosis. DIGEST DIS SCI. 2011;56(1):188\u0026ndash;96.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZeng J, Zhou G, Pan F. Clinical Analysis of Intestinal Tuberculosis: A Retrospective Study. J CLIN MED 2023, 12(2).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHuang S, Yi FM, Zhou R, Chen M, Lei Y, Zhao JZ, Zhang H, Xia B. The utility of platelet, mean platelet volume, and red cell distribution width in the diagnosis of active Crohn's disease and intestinal tuberculosis. SAUDI MED J. 2013;34(11):1161\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLoue VA, Gbary E, Koui S, Akpa B, Kouassi A. Bilateral Ovarian Fibrothecoma Associated with Ascites, Bilateral Pleural Effusion, and Marked Elevated Serum CA-125. Case Rep Obstet Gynecol. 2013;2013:189072.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFavresse J, Lippi G, Roy PM, Chatelain B, Jacqmin H, Ten CH, Mullier F. D-dimer: Preanalytical, analytical, postanalytical variables, and clinical applications. CRIT REV CL LAB SCI. 2018;55(8):548\u0026ndash;77.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"intestinal tuberculosis, Crohn's disease, clinical characteristics","lastPublishedDoi":"10.21203/rs.3.rs-8403225/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8403225/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e \u003cp\u003eAlthough intestinal tuberculosis (ITB) and Crohn's disease (CD) have different treatment, but their presentations are similar, therefore, distinguishing them remains a challenge for physicians. This study aimed to determine the differences between the two from the perspective of primary hospitals according to clinical characteristics.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eA total of 197 patients (CD 90 and ITB 107) were retrospectively enrolled from December 2013 to May 2024 in Affiliated Hospital of North Sichuan Medical College. Their characteristics, clinical features, laboratory, endoscopic, and radiographic features were recorded. SPSS 26.0 was used to perform Pearson chi-square test.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eWe found that the age of onset of CD was younger than that of ITB (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), ITB was more likely to be combined with active pulmonary tuberculosis (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), pleural effusion (p\u0026thinsp;=\u0026thinsp;0.001) and ascites (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Radiologically, Compared to ITB, CD is more likely to be combined with the colonic wall thickening(p\u0026thinsp;=\u0026thinsp;0.011), small bowel wall thickening(p\u0026thinsp;=\u0026thinsp;0.004), and colonic and small bowel wall thickening morphology (p\u0026thinsp;=\u0026thinsp;0.001). On endoscopic images, longitudinal ulcers can effectively distinguish CD (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and circular ulcers can distinguish ITB from CD(p\u0026thinsp;=\u0026thinsp;0.002). There were statistically significant differences in clinical manifestations between the two groups, including abdominal pain, diarrhea, hematochezia, abdominal distension, fever, night sweats, cough and sputum, intestinal obstruction, and perianal abscess(p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Interestingly, in blood tests, we found significant differences in white blood cell count, D-dimer, fibrinogen degradation products, serum albumin, and serum cancer antigen 125 ( CA125) between the two groups(p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). There were significant differences in the white blood cell (WBC)/hematocrit (HCT) ratio and platelet/activated partial thromboplastin time (APTT) ratio between the two groups(p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e \u003cp\u003eIn our cohort, many clinical features could accurately distinguish CD from ITB. Our newly discovered differences can serve as an accurate and convenient diagnostic tool to distinguish between CD and ITB, facilitating clinical decision-making.\u003c/p\u003e","manuscriptTitle":"Coagulation-related indicators serve as new and effective indicators for distinguishing Crohn's disease and intestinal tuberculosis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-09 15:07:51","doi":"10.21203/rs.3.rs-8403225/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-20T01:09:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"131782142622980172371111369217615210871","date":"2026-04-13T08:40:08+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-06T15:28:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"178728139997989205086267666289681026860","date":"2026-04-06T12:53:35+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-02T16:16:48+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-11T05:54:14+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-29T07:19:39+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-27T10:23:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Gastroenterology","date":"2025-12-27T10:16:42+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"98873b38-7447-47e6-bdc0-f872ce1750d3","owner":[],"postedDate":"April 9th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-09T15:07:51+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-09 15:07:51","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8403225","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8403225","identity":"rs-8403225","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}