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[Gastric outlet obstruction in chronic granulomatous disease]
M Born1, W A Willinek, C Hassan
1Radiologische Universitätsklinik Bonn.
Abstract:
We report the case of a three year old dystrophic boy who suffered from vomiting, loss of weight and fever. In the history there were several episodes of severe infections which had repeatedly lead to hospitalisation. The cause of the actual disorder was a gastric manifestation of chronic granulomatous disease, which led by an inflammatory thickening of the gastric wall to a gastric outlet obstruction. Treatment with prednisone and gamma interferon normalised the thickness of the gastric wall and gastric outlet function. A prophylactic treatment with antibiotic and antifungeal agents was started. During the following 13 months no further severe infections were observed. We discuss incidence, kinds of manifestation, diagnostics and therapeutical options of the disease and give an overview of the literature.
Insights
A three-year-old boy with chronic granulomatous disease (CGD) experienced gastric outlet obstruction due to inflammation. Treatment with prednisone and gamma interferon resolved symptoms, and prophylactic antibiotics prevented further infections.
Area of Science:
- Pediatrics
- Immunology
- Gastroenterology
Background:
- Chronic granulomatous disease (CGD) is a primary immunodeficiency affecting phagocyte function.
- Gastric manifestations of CGD are rare but can lead to serious complications like obstruction.
Observation:
- A 3-year-old boy presented with vomiting, weight loss, and fever, indicative of severe infections.
- Imaging revealed inflammatory thickening of the gastric wall causing gastric outlet obstruction.
Findings:
- Treatment with prednisone and gamma interferon successfully reduced gastric wall thickness and restored gastric outlet function.
- Prophylactic antibiotic and antifungal therapy prevented recurrent severe infections over 13 months.
Implications:
- This case highlights the importance of considering CGD in children with recurrent infections and gastrointestinal symptoms.
- Early diagnosis and appropriate treatment, including prophylactic antimicrobials, can significantly improve outcomes in CGD patients with gastric involvement.