{"id":2763,"date":"2026-09-30T13:14:14","date_gmt":"2026-09-30T08:14:14","guid":{"rendered":"https:\/\/journal.nncf.kz\/?p=2763"},"modified":"2026-10-10T13:17:11","modified_gmt":"2026-10-10T08:17:11","slug":"%d0%b3%d0%b5%d0%bd%d0%b5%d1%80%d0%b0%d0%bb%d0%b8%d0%b7%d0%be%d0%b2%d0%b0%d0%bd%d0%bd%d1%8b%d0%b9-%d1%82%d1%83%d0%b1%d0%b5%d1%80%d0%ba%d1%83%d0%bb%d0%b5%d0%b7-%d1%83-%d0%bf%d0%b0%d1%86%d0%b8%d0%b5","status":"publish","type":"post","link":"https:\/\/journal.nncf.kz\/en\/%d0%b3%d0%b5%d0%bd%d0%b5%d1%80%d0%b0%d0%bb%d0%b8%d0%b7%d0%be%d0%b2%d0%b0%d0%bd%d0%bd%d1%8b%d0%b9-%d1%82%d1%83%d0%b1%d0%b5%d1%80%d0%ba%d1%83%d0%bb%d0%b5%d0%b7-%d1%83-%d0%bf%d0%b0%d1%86%d0%b8%d0%b5\/","title":{"rendered":"GENERALIZED TUBERCULOSIS IN THE PATIENT PATIENTS WITH CROHN’S DISEASE ON THE BACKGROUND OF IMMUNOSUPPRESSIVE THERAPY: CLINICAL CONSEQUENCES OF LACK OF SCREENING AND MONITORING OF LATENT TUBERCULOSIS INFECTION (a clinical case)"},"content":{"rendered":"

Received: June 4, 2026<\/em>
\nAccepted for publication: July 19, 2026<\/em>
\nPublished online: September 30, 2026<\/em>
\nUDC: 616.24-002.5-06:616.34-002-022:615.281
\nDOI: 10.26212\/2227-1937.2026.12.70.011<\/a><\/p>\n

 <\/p>\n

GENERALIZED TUBERCULOSIS IN THE PATIENT PATIENTS WITH CROHN’S DISEASE ON THE BACKGROUND OF IMMUNOSUPPRESSIVE THERAPY: CLINICAL CONSEQUENCES OF LACK OF SCREENING AND MONITORING OF LATENT TUBERCULOSIS INFECTION (a clinical case)<\/em><\/p>\n

\u00a0<\/strong><\/p>\n

Shuzheyev B.S.\u00b9, Kesebayev T.K.\u00b9, Rakisheva A.S.\u00b2
\n<\/strong>\u00b9 National Scientific Center of Phthisiopulmonology, Ministry of Health of the Republic of Kazakhstan, <\/em>Almaty, Kazakhstan<\/em><\/p>\n

\u00b2 NJSC \u201cAsfendiyarov Kazakh National Medical University\u201d, <\/em>Almaty, Kazakhstan<\/em><\/p>\n

 <\/p>\n

Introduction:<\/strong> Crohn\u2019s disease (CD) is a chronic inflammatory bowel disease characterized by impaired immune regulation. Patients with CD are at increased risk of infectious complications, including tuberculosis (TB), particularly during immunosuppressive therapy. Delayed screening for latent tuberculosis infection (LTBI) and insufficient regular monitoring may contribute to the development of generalized TB, worsening the prognosis and increasing mortality from this otherwise treatable disease.<\/p>\n

Objective:<\/strong> To evaluate the clinical consequences of delayed LTBI screening and absence of preventive therapy in patients with Crohn\u2019s disease, as well as to identify risk factors for the development of generalized forms of tuberculosis in patients with comorbid conditions.<\/p>\n

Materials and methods:<\/strong> Informed voluntary consent was obtained from the patient for the presentation and publication of this clinical case without disclosure of personal data. The patient was examined according to an approved diagnostic algorithm. During anti-tuberculosis treatment, the patient developed intestinal obstruction complicated by peritonitis, for which a laparotomy with end transverse colostomy formation, abdominal cavity sanitation, and drainage was performed. However, in the postoperative period, the condition was further complicated by the development of dynamic small bowel obstruction and diffuse fibrinopurulent peritonitis. Histological examination of the surgical material was performed at the Pathomorphology Laboratory of the National Scientific Center of Phthisiopulmonology of the Ministry of Health of the Republic of Kazakhstan.<\/p>\n

Results:<\/strong> Despite the diagnostic challenges of intestinal tuberculosis, in which histological examination of surgical material played a decisive role, effective management of drug-resistant tuberculosis was achieved.<\/p>\n

Discussion:<\/strong> This clinical case demonstrates the complexity of diagnosing intestinal tuberculosis in a patient with Crohn\u2019s disease. Despite ongoing anti-tuberculosis therapy, severe complications developed, requiring emergency surgical intervention. Histological examination of the surgical material played a key role in confirming the diagnosis of intestinal tuberculosis, allowing for treatment modification and a favorable outcome. This case highlights the need for a high index of suspicion for tuberculosis in patients receiving immunosuppressive therapy, particularly in the presence of risk factors, as well as the importance of timely LTBI screening prior to initiation of immunosuppression and preventive treatment when indicated. In complex differential diagnostic situations, a comprehensive approach is required, including histological evaluation when intestinal tuberculosis is suspected. Multidisciplinary collaboration between gastroenterologists, surgeons, phthisiologists, and morphologists is essential for optimizing treatment strategies.<\/p>\n

This case also emphasizes the necessity of developing clear diagnostic and therapeutic algorithms for tuberculosis in patients with inflammatory bowel diseases receiving immunosuppressive therapy.<\/p>\n

Conclusion:<\/strong> This clinical case indicates the need for mandatory screening for tuberculosis and tuberculosis infection before starting immunosuppressive therapy and regular monitoring in patients with inflammatory bowel diseases. Late diagnosis of latent tuberculosis infection significantly increases the risk of developing severe forms of the disease and worsens the prognosis. It is recommended to strengthen monitoring of compliance with screening protocols in patients with inflammatory bowel diseases (IBD). Key words: tuberculosis, Crohn’s disease, comorbid diseases, screening and preventive treatment of tuberculosis infection.<\/p>\n

Keywords:<\/strong> tuberculosis, Crohn\u2019s disease, comorbid conditions, screening and preventive treatment of tuberculosis infection.<\/p>\n\n