Gastrointestinal and Hepatic Manifestations of Chronic Granulomatous Disease

J Allergy Clin Immunol Pract. 2023 Jan 13;S2213-2198(23)00050-8. doi: 10.1016/j.jaip.2022.12.039. Online ahead of print.

Abstract

Chronic granulomatous disease (CGD) is a rare inborn error of immunity, resulting from a defect in nicotinamide adenine dinucleotide phosphate (NADPH) oxidation and decreased production of phagocyte reactive oxygen species. The main clinical manifestations are recurrent infections and chronic inflammatory disorders. Current approaches to management include antimicrobial prophylaxis and control of inflammatory complications. Hematopoietic stem cell transplantation (HSCT) or gene therapy can provide definitive treatment. Gastrointestinal and hepatic manifestations are common in CGD and include structural changes, dysmotility, CGD-associated inflammatory bowel disease, liver abscesses, and non-cirrhotic portal hypertension. The findings can be heterogenous and the management is complex in light of the underlying immune dysfunction. This review describes the various clinical findings and the latest studies in management of gastrointestinal and hepatic manifestations in CGD, as well as the management experience at the National Institutes of Health.

Keywords: Abscess; CGD; IBD; Motility; Portal Hypertension.