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

Sumona Bhattacharya; Yilun Koethe; Alexander Ling; Natasha Kamal; Sajneet Khangura; Meghna Alimchandani; Martha M Quezado; Christa S Zerbe; Harry L Malech; John I Gallin; Steven M Holland; Theo Heller; Elizabeth Jones; Aradhana M Venkatesan

doi:10.1007/s10620-021-06978-4

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

Dig Dis Sci. 2022 May;67(5):1831-1842. doi: 10.1007/s10620-021-06978-4. Epub 2021 May 1.

Authors

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.
² Miami Cardiac and Vascular Institute, 8900 N. Kendal Drive, Miami, FL, 33176, USA.
³ Radiology and Imaging Sciences, National Institutes of Health, 10 Center Dr., MSC 1182, Bethesda, MD, 20892, USA.
⁴ Division of Gastroenterology, University of Maryland School of Medicine, 22 South Greene St, N3W156, Baltimore, MD, 21201, USA.
⁵ Gastroenterology Consultants of San Antonio, 11211 State Hwy 151, Medical Plaza 1, Ste. 250, San Antonio, TX, 78251, USA.
⁶ Laboratory of Pathology, National Cancer Institute, National Institutes of Health, 10 Center Dr., Magnuson CC, Room 2A10, Bethesda, MD, 20892, USA.
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.
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.
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.
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.
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.
¹² Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr., Building 10, MSC 1182, Bethesda, MD, 20892, USA.
¹³ Abdominal Imaging, Division of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. avenkatesan@mdanderson.org.

PMID: 33934254
DOI: 10.1007/s10620-021-06978-4

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.

Keywords: CGD colitis; Chronic granulomatous disease; Inflammatory bowel disease; Radiography.

Publication types

Research Support, N.I.H., Intramural

MeSH terms

Endoscopy, Gastrointestinal
Gastrointestinal Diseases* / complications
Gastrointestinal Diseases* / etiology
Granulomatous Disease, Chronic* / complications
Granulomatous Disease, Chronic* / diagnostic imaging
Humans
Inflammation / complications
Retrospective Studies
Tomography, X-Ray Computed