A Rare Case of Intestinal Tuberculosis Mimicking Colon Cancer in a Chronic Kidney Disease Patient
Intestinal Tuberculosis (ITB) is an uncommon form of extrapulmonary TB that poses a diagnostic challenge due to its nonspecific symptoms and radiological resemblance to malignancy. It is particularly rare in patients with End-Stage Renal Disease (ESRD) on haemodialysis, where immunosuppression incre...
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JCDR Research and Publications Private Limited
2025-07-01
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| Online Access: | https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&month=July&volume=19&issue=7&page=OD18-OD20&id=21264 |
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| author | Anuja Makan Pavan Wakhare Tushar Dighe Charan Bale Atul Sajgure |
| author_facet | Anuja Makan Pavan Wakhare Tushar Dighe Charan Bale Atul Sajgure |
| author_sort | Anuja Makan |
| collection | DOAJ |
| description | Intestinal Tuberculosis (ITB) is an uncommon form of extrapulmonary TB that poses a diagnostic challenge due to its nonspecific symptoms and radiological resemblance to malignancy. It is particularly rare in patients with End-Stage Renal Disease (ESRD) on haemodialysis, where immunosuppression increases susceptibility to infections. The clinical presentation often mimics inflammatory bowel disease or gastrointestinal malignancy, leading to potential misdiagnosis and treatment delays. Despite advancements in diagnostic techniques, ITB remains a difficult diagnosis, especially in dialysis-dependent patients who may have negative TB screening tests. We present the case of a 47-year-old male with ESRD on haemodialysis who developed progressive weakness, anorexia, and significant weight loss over five months. Imaging studies, including an abdominal CT scan and whole-body Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) revealed a mass in the ascending colon with associated lymphadenopathy, raising strong suspicion for malignancy. Colonoscopy showed mucosal ulceration, and biopsy findings confirmed caseating granulomas, establishing the diagnosis of ITB. Notably, initial TB screening tests, including sputum examination and Mantoux test, were negative. The patient was started on a standard anti-tubercular regimen, leading to gradual improvement in symptoms. This case highlights the diagnostic dilemma posed by ITB in dialysis patients, emphasising the importance of maintaining a high index of suspicion, especially in those with persistent gastrointestinal symptoms. Early recognition and treatment are crucial to preventing complications, as misdiagnosis can result in unnecessary interventions and delayed therapy for a potentially life-threatening condition. |
| format | Article |
| id | doaj-art-4fdf839dbe254ef390fbae5c0918f6c4 |
| institution | Kabale University |
| issn | 2249-782X 0973-709X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj-art-4fdf839dbe254ef390fbae5c0918f6c42025-08-20T03:32:54ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-07-01197OD18OD2010.7860/JCDR/2025/73354.21264A Rare Case of Intestinal Tuberculosis Mimicking Colon Cancer in a Chronic Kidney Disease PatientAnuja Makan0Pavan Wakhare1Tushar Dighe2Charan Bale3Atul Sajgure4Resident, Department of Nephrology, D. Y. Patil Medical College, Pimpri, Pune, Maharashtra, India.Associate Professor, Department of Nephrology, D. Y. Patil Medical College, Pimpri, Pune, Maharashtra, India.Professor, Department of Nephrology, D. Y. Patil Medical College, Pimpri, Pune, Maharashtra, India.Professor, Department of Nephrology, D. Y. Patil Medical College, Pimpri, Pune, Maharashtra, India.Professor, Department of Nephrology, D. Y. Patil Medical College, Pimpri, Pune, Maharashtra, India.Intestinal Tuberculosis (ITB) is an uncommon form of extrapulmonary TB that poses a diagnostic challenge due to its nonspecific symptoms and radiological resemblance to malignancy. It is particularly rare in patients with End-Stage Renal Disease (ESRD) on haemodialysis, where immunosuppression increases susceptibility to infections. The clinical presentation often mimics inflammatory bowel disease or gastrointestinal malignancy, leading to potential misdiagnosis and treatment delays. Despite advancements in diagnostic techniques, ITB remains a difficult diagnosis, especially in dialysis-dependent patients who may have negative TB screening tests. We present the case of a 47-year-old male with ESRD on haemodialysis who developed progressive weakness, anorexia, and significant weight loss over five months. Imaging studies, including an abdominal CT scan and whole-body Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) revealed a mass in the ascending colon with associated lymphadenopathy, raising strong suspicion for malignancy. Colonoscopy showed mucosal ulceration, and biopsy findings confirmed caseating granulomas, establishing the diagnosis of ITB. Notably, initial TB screening tests, including sputum examination and Mantoux test, were negative. The patient was started on a standard anti-tubercular regimen, leading to gradual improvement in symptoms. This case highlights the diagnostic dilemma posed by ITB in dialysis patients, emphasising the importance of maintaining a high index of suspicion, especially in those with persistent gastrointestinal symptoms. Early recognition and treatment are crucial to preventing complications, as misdiagnosis can result in unnecessary interventions and delayed therapy for a potentially life-threatening condition.https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&month=July&volume=19&issue=7&page=OD18-OD20&id=21264end-stage renal diseasekidney diseasesmycobacterium infectionsrenal insufficiency chronictuberculosis extrapulmonary |
| spellingShingle | Anuja Makan Pavan Wakhare Tushar Dighe Charan Bale Atul Sajgure A Rare Case of Intestinal Tuberculosis Mimicking Colon Cancer in a Chronic Kidney Disease Patient Journal of Clinical and Diagnostic Research end-stage renal disease kidney diseases mycobacterium infections renal insufficiency chronic tuberculosis extrapulmonary |
| title | A Rare Case of Intestinal Tuberculosis Mimicking Colon Cancer in a Chronic Kidney Disease Patient |
| title_full | A Rare Case of Intestinal Tuberculosis Mimicking Colon Cancer in a Chronic Kidney Disease Patient |
| title_fullStr | A Rare Case of Intestinal Tuberculosis Mimicking Colon Cancer in a Chronic Kidney Disease Patient |
| title_full_unstemmed | A Rare Case of Intestinal Tuberculosis Mimicking Colon Cancer in a Chronic Kidney Disease Patient |
| title_short | A Rare Case of Intestinal Tuberculosis Mimicking Colon Cancer in a Chronic Kidney Disease Patient |
| title_sort | rare case of intestinal tuberculosis mimicking colon cancer in a chronic kidney disease patient |
| topic | end-stage renal disease kidney diseases mycobacterium infections renal insufficiency chronic tuberculosis extrapulmonary |
| url | https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2025&month=July&volume=19&issue=7&page=OD18-OD20&id=21264 |
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