Review for 10.1186/s12876-023-02887-0 (2023)

Title: Differentiating Gastrointestinal Tuberculosis and Crohn's Disease- A comprehensive
review
Version: 2 Date: 01 Jun 2023
Reviewer's report:
The article “Differentiating Gastrointestinal Tuberculosis and Crohn's Disease- A
comprehensive review” covers an important topic of practical significance today. It addresses
all aspects of differentiating the two disorders, including newer diagnostic modalities  that are
particularly interesting and not covered by other reviews on this topic. This article could be a
good reference source for those working  in this field.
There are a few issues that need to be addressed:
1. The authors have understandably tried to present the findings of multiple investigators on
each topic but this has resulted in much repetition of points under each heading. I am mentioning
some of the examples, though the list is not exhaustive. The article will read better if this issue
is addressed.
1.1. Introduction Para 3: The same clinical features are mentioned twice: in the sentences
beginning “The typical clinical features…” and “The frequent clinical manifestations…”
1.2. Clinical Presentation Para 3:
The sentences “On the contrary, diarrhea, bleeding per rectum and perianal disease are more
commonly seen in CD” and the next sentence referring to the study by Makharia et al address
the same three points and could be combined into one sentence with two references.
The difference in duration of illness is mentioned in all paras.
1.3      Endoscopic findings Para 1 and 2
The sites involved – ileocecal – are mentioned in both paras and that left-sided colitis is more
common in CD is mentioned three times.
Ulcers in TB are mentioned in both paras. The sentence in the 2nd para could be
modified to “Apart from ulcers, GITB can have strictures….”
1.4     Histopathology Para 7
The features of tuberculous granulomas are mentioned twice in the same para – multiple, large ,
confluent and caseating.
2. Under the heading Imaging Features, in the last two paras the authors have mentioned that
symmetric bowel wall thickening is more common in CD and then that eccentric strictures are
usually seen in CD. Are both these correct?
3. Under the heading Histopathology, Para 8, the authors have referred to lymphatic granulomas.
The term should be ‘granulomas in lymph nodes’ which are different from lymphatic
granulomas.
4. Under the heading Models based on multiple parameters, the Reference (18) mentioned for
the sentence “Another Indian model…” would be better replaced by the reference to that article
rather than to a review of it.
5. The grammar needs to be checked professionally. A few instances where it could be improved
are mentioned below
5.1 Histopathology para 7: The sentence that GITB presents areas of localized infection should
not begin with the word “Whereas”. The sentence would read better as “GITB, on the other
hand, presents areas of localized…”
5.2 Histopathology para 8: The last sentence should not begin with a “But”. It would read better
as “In a retrospective study however, focal lesions…”
5.3 Models based on multiple parameters para 1: The word attempts has been mentioned twice
in the last sentence. The second mention of “in attempts” can be deleted.
5.4 Models based on multiple parameters para 2: in the 6th line the word “least” should be
replaced by “lowest”
5.5 Newer testing methods and use of artificial intelligence para 2: First sentence, the word “the”
before Crohn’s disease… should be deleted.
5.6 Newer testing methods and use of artificial intelligence para 2: In the sentence “The pattern
of polarization of macrophage..” should use the term “macrophages”. The same applies to the
last sentence in this para.
5.7 Newer testing methods and use of artificial intelligence para 3: The sentence “Matrix-
assisted laser desorption…” would read better as “Matrix- assisted laser desorption ionization
– time of flight (MALDI-TOF) is a mass spectrometry technique that can be used on serum
samples to identify differentially expressed proteins.”
5.8 Newer testing methods and use of artificial intelligence para 3, line 7 and line
9: “proteomic” should read “proteomics”
5.9 Response to antitubercular therapy para 2 line 11:  should read “…an opportunity for early
evaluation…”
5.9 Response to antitubercular therapy para 2 last line: should read “However, most MDR-TB
patients also have associated…”