Louis Edouard
Department of Gastroenterology, Centre Hospitalier Universitaire, Liège, Belgium.
Curr Opin Gastroenterol. 2015 Jul;31(4):283-9. doi: 10.1097/MOG.0000000000000183.
Inflammatory bowel diseases (IBDs) represent a heterogeneous entity whose diagnosis is sometimes difficult to ascertain. Many pathological processes may mimic IBD phenotypes. Among the classical differential diagnoses are enteric infections and infestations as well as drug toxicity. However, recently, more specific differential diagnoses have been included, including monogenic causes of gastrointestinal tract inflammation, particularly in young children. The purpose of the present review is to describe the differential diagnosis of IBD, putting it in a specific clinical and demographic context. This differential diagnosis will be discussed specifically for young children, elderly patients, and immunosuppressed patients.
We will focus on the most recent findings and concepts, including monogenic diseases in young children, diverticular disease-associated colitis in elderly patients, and toxic colitis in patients receiving immunosuppressants such as mycophenolate mofetil or biologics such as ipilimumab.
The aim of this review is to alert the clinician dealing with IBD, concerning a series of specific diagnoses that should be recognized because they may require specific treatment, different from the ones of classical idiopathic IBD.
炎症性肠病（IBD）是一种异质性疾病，其诊断有时难以确定。许多病理过程可能模仿IBD的表型。经典的鉴别诊断包括肠道感染、寄生虫感染以及药物毒性。然而，最近纳入了更具特异性的鉴别诊断，包括胃肠道炎症的单基因病因，尤其是在幼儿中。本综述的目的是描述IBD的鉴别诊断，并将其置于特定的临床和人口统计学背景中。将针对幼儿、老年患者和免疫抑制患者具体讨论这种鉴别诊断。
我们将重点关注最新的发现和概念，包括幼儿的单基因疾病、老年患者的憩室病相关性结肠炎以及接受霉酚酸酯等免疫抑制剂或伊匹木单抗等生物制剂治疗的患者的中毒性结肠炎。
本综述的目的是提醒处理IBD的临床医生注意一系列应被识别的特定诊断，因为它们可能需要与经典特发性IBD不同的特定治疗。
