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

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.