Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Concomitant use of corticosteroid and antimicrobials for liver abscesses in patients with chronic granulomatous disease

  • Shin, Kyung-Sue (Department of Pediatrics, Gyeongsang National University Changwon Hospital) ;
  • Lee, Mu Suk (Department of Diagnostic Radiology, Jeju National University School of Medicine)
  • 투고 : 2014.04.23
  • 심사 : 2014.07.19
  • 발행 : 2016.04.15
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초록

Chronic granulomatous disease (CGD) is a rare inherited disorder caused by defective nicotinamide adenine dinucleotide phosphate oxidase enzyme and characterized by recurrent bacterial and fungal infections. Although liver abscess is a common manifestation of CGD, its management in CGD patients is not well-defined. In addition, the generalized guidelines for treating liver abscesses do not necessarily apply to CGD patients. Corticosteroids are commonly used to control granulomatous complications, such as inflammatory gastrointestinal and genitourinary lesions, in patients with CGD, Corticosteroids have also been used in combination with antimicrobials to treat refractory infections in patients with CGD. Because corticosteroids are capable of suppressing symptomatic inflammation, all potential infections must be adequately controlled prior to corticosteroid initiation. We report 3 typical CGD cases with liver abscesses refractory to conventional treatments that were successfully treated with the concomitant use of corticosteroid and antimicrobials. It remains unclear whether corticosteroid therapy is required for liver abscesses in CGD refractory to conventional treatments. However, based on our observations, use of corticosteroids in combination with optimal antimicrobials should be considered for refractory liver abscesses in CGD.

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참고문헌

  1. Segal BH, Veys P, Malech H, Cowan MJ. Chronic granulomatous disease: lessons from a rare disorder. Biol Blood Marrow Transplant 2011;17(1 Suppl):S123-31. https://doi.org/10.1016/j.bbmt.2010.09.008
  2. Heyworth PG, Cross AR, Curnutte JT. Chronic granulomatous disease. Curr Opin Immunol 2003;15:578-84. https://doi.org/10.1016/S0952-7915(03)00109-2
  3. Winkelstein JA, Marino MC, Johnston RB Jr, Boyle J, Curnutte J, Gallin JI, et al. Chronic granulomatous disease. Report on a national registry of 368 patients. Medicine (Baltimore) 2000;79: 155-69. https://doi.org/10.1097/00005792-200005000-00003
  4. van den Berg JM, van Koppen E, Ahlin A, Belohradsky BH, Bernatowska E, Corbeel L, et al. Chronic granulomatous disease: the European experience. PLoS One 2009;4:e5234. https://doi.org/10.1371/journal.pone.0005234
  5. Lublin M, Bartlett DL, Danforth DN, Kauffman H, Gallin JI, Malech HL, et al. Hepatic abscess in patients with chronic granulomatous disease. Ann Surg 2002;235:383-91. https://doi.org/10.1097/00000658-200203000-00010
  6. Yamazaki-Nakashimada MA, Stiehm ER, Pietropaolo-Cienfuegos D, Hernandez-Bautista V, Espinosa-Rosales F. Corticosteroid therapy for refractory infections in chronic granulomatous disease: case reports and review of the literature. Ann Allergy Asthma Immunol 2006;97:257-61. https://doi.org/10.1016/S1081-1206(10)60023-3
  7. Leiding JW, Freeman AF, Marciano BE, Anderson VL, Uzel G, Malech HL, et al. Corticosteroid therapy for liver abscess in chronic granulomatous disease. Clin Infect Dis 2012;54:694-700. https://doi.org/10.1093/cid/cir896
  8. Roos D, Kuhns DB, Maddalena A, Roesler J, Lopez JA, Ariga T, et al. Hematologically important mutations: X-linked chronic granulomatous disease (third update). Blood Cells Mol Dis 2010;45:246-65. https://doi.org/10.1016/j.bcmd.2010.07.012
  9. Roos D, Kuhns DB, Maddalena A, Bustamante J, Kannengiesser C, de Boer M, et al. Hematologically important mutations: the autosomal recessive forms of chronic granulomatous disease (second update). Blood Cells Mol Dis 2010;44:291-9. https://doi.org/10.1016/j.bcmd.2010.01.009
  10. Matute JD, Arias AA, Wright NA, Wrobel I, Waterhouse CC, Li XJ, et al. A new genetic subgroup of chronic granulomatous disease with autosomal recessive mutations in p40 phox and selective defects in neutrophil NADPH oxidase activity. Blood 2009; 114:3309-15. https://doi.org/10.1182/blood-2009-07-231498
  11. Rhim JW, Kim KH, Kim DS, Kim BS, Kim JS, Kim CH, et al. Prevalence of primary immunodeficiency in Korea. J Korean Med Sci 2012;27:788-93. https://doi.org/10.3346/jkms.2012.27.7.788
  12. Kim YM, Park JE, Kim JY, Lim HK, Nam JK, Cho M, et al. Genetic analysis of 10 unrelated Korean families with p22-phox-deficient chronic granulomatous disease: an unusually identical mutation of the CYBA gene on Jeju Island, Korea. J Korean Med Sci 2009;24: 1045-50. https://doi.org/10.3346/jkms.2009.24.6.1045
  13. Holland SM. Chronic granulomatous disease. Hematol Oncol Clin North Am 2013;27:89-99. https://doi.org/10.1016/j.hoc.2012.11.002
  14. Hussain N, Feld JJ, Kleiner DE, Hoofnagle JH, Garcia-Eulate R, Ahlawat S, et al. Hepatic abnormalities in patients with chronic granulomatous disease. Hepatology 2007;45:675-83. https://doi.org/10.1002/hep.21524
  15. Freeman AF, Marciano BE, Anderson VL, Uzel G, Costas C, Holland SM. Corticosteroids in the treatment of severe nocardia pneumonia in chronic granulomatous disease. Pediatr Infect Dis J 2011;30:806-8. https://doi.org/10.1097/INF.0b013e318218181d

피인용 문헌

  1. Use of corticosteroids as an alternative to surgical treatment for liver abscesses in chronic granulomatous disease vol.63, pp.12, 2016, https://doi.org/10.1002/pbc.26140
  2. Mastoidectomy in a child with chronic granulomatous disease vol.78, pp.10, 2016, https://doi.org/10.12968/hmed.2017.78.10.586
  3. Successful hepatectomy for hepatic abscess with chronic granulomatous disease: a case report vol.3, pp.None, 2016, https://doi.org/10.1186/s40792-017-0333-z
  4. Clinical manifestations and genetic analysis of 4 children with chronic granulomatous disease vol.99, pp.23, 2016, https://doi.org/10.1097/md.0000000000020599
  5. Recent advances in chronic granulomatous disease vol.7, pp.1, 2020, https://doi.org/10.1016/j.gendis.2019.07.010