Gastrointestinal and Hepatic Manifestations of Chronic Granulomatous Disease

Chronic granulomatous disease (CGD) is a rare inborn error immunity, resulting from a defect in nicotinamide adenine dinucleotide phosphate oxidation and decreased production 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 therapy can provide definitive treatment. Gastrointestinal and hepatic manifestations are common in CGD and include structural changes, dysmotility, CGD-associated inflamma- tory bowel disease, liver abscesses, and noncirrhotic portal hypertension. The findings can be heterogeneous, and the management is complex in light of the underlying immune dysfunction. This review describes the various clinical find- ings 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. Published by Elsevier Inc. on behalf of the Amer- ican Academy of Allergy, Asthma & Immunology (J Allergy Clin Immunol Pract 2023;11:1401-16)