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Gastrointestinal Computed Tomography Findings in Chronic Granulomatous Disease with Subgroup Clinicopathologic Analysis

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Abstract

Background

Chronic granulomatous disease (CGD) is a rare primary immunodeficiency which can lead to gastrointestinal (GI) complications including inflammatory bowel disease. Radiographic findings in this cohort have not been well described.

Aims

To describe the frequency and spectrum of gastrointestinal abnormalities seen on computed tomography (CT) in patients with CGD and determine whether radiography was predictive of endoscopic or histopathologic inflammatory findings.

Methods

A retrospective review was conducted on 141 consecutive CGD patients seen at the National Institutes of Health between 1988 and 2011. All corresponding CTs were reviewed for gastrointestinal abnormalities including wall thickening. Endoscopic and histopathologic findings were reviewed in subjects with documented endoscopy within 30 days of an imaging study. Findings were compared between patients with and without wall thickening on CT to determine whether bowel wall thickening was predictive of endoscopic or histologic inflammatory findings.

Results

Two hundred and ninety-two CTs were reviewed. GI wall thickening was present on CT in 61% of patients (n = 86). Among a subgroup of 20 patients who underwent endoscopy at the time of their imaging, there was a statistically significant correlation between radiographic gastrointestinal wall thickening and endoscopic inflammation in the same intestinal segment (p = 0.035). Additionally, there was a significant correlation between radiographic gastrointestinal wall thickening and inflammatory features on histopathology (p = 0.02).

Conclusions

GI abnormalities are commonly observed on CT in CGD patients. Bowel wall thickening correlates with endoscopic and histopathologic evidence of inflammation. These findings may be used to better facilitate directed endoscopic assessment and histopathologic sampling in patients with CGD.

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Funding

This work was supported by the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health Clinical Center, and the National Institutes of Health Intramural Research Program. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government.

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Authors and Affiliations

  1. Digestive Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Dr., Room 5-2740, Bethesda, MD, 20892, USA

    Sumona Bhattacharya

  2. Miami Cardiac and Vascular Institute, 8900 N. Kendal Drive, Miami, FL, 33176, USA

    Yilun Koethe

  3. Radiology and Imaging Sciences, National Institutes of Health, 10 Center Dr., MSC 1182, Bethesda, MD, 20892, USA

    Alexander Ling

  4. Division of Gastroenterology, University of Maryland School of Medicine, 22 South Greene St, N3W156, Baltimore, MD, 21201, USA

    Natasha Kamal

  5. Gastroenterology Consultants of San Antonio, 11211 State Hwy 151, Medical Plaza 1, Ste. 250, San Antonio, TX, 78251, USA

    Sajneet Khangura

  6. Laboratory of Pathology, National Cancer Institute, National Institutes of Health, 10 Center Dr., Magnuson CC, Room 2A10, Bethesda, MD, 20892, USA

    Meghna Alimchandani & Martha M. Quezado

  7. Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 10 Center Dr., MSC 1460, Bethesda, MD, 20892, USA

    Christa S. Zerbe

  8. Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 10 Center Dr., Rm 5-3750, MSC 1456, Bethesda, MD, 20892, USA

    Harry L. Malech

  9. Clinical Pathophysiology Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 10 Center Dr., Room 6-2551, Bethesda, MD, 20892, USA

    John I. Gallin

  10. Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, CRC B3 4141 MSC 1684, Bethesda, MD, 20892, USA

    Steven M. Holland

  11. Translational Hepatology Unit, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Dr., Building 10, Room 9C432B, 10 Center Dr., Bethesda, MD, 20814, USA

    Theo Heller

  12. Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Building 10, MSC 1182, Bethesda, MD, 20892, USA

    Elizabeth Jones

  13. Abdominal Imaging, Division of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Aradhana M. Venkatesan

Authors
  1. Sumona Bhattacharya
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  2. Yilun Koethe
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  3. Alexander Ling
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  4. Natasha Kamal
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  5. Sajneet Khangura
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  6. Meghna Alimchandani
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  7. Martha M. Quezado
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  8. Christa S. Zerbe
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  9. Harry L. Malech
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  10. John I. Gallin
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  11. Steven M. Holland
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  12. Theo Heller
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  13. Elizabeth Jones
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  14. Aradhana M. Venkatesan
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Correspondence to Aradhana M. Venkatesan.

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Bhattacharya, S., Koethe, Y., Ling, A. et al. Gastrointestinal Computed Tomography Findings in Chronic Granulomatous Disease with Subgroup Clinicopathologic Analysis. Dig Dis Sci 67, 1831–1842 (2022). https://doi.org/10.1007/s10620-021-06978-4

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  • DOI: https://doi.org/10.1007/s10620-021-06978-4

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