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Gastrointestinal Computed Tomography Findings in Chronic Granulomatous Disease with Subgroup Clinicopathologic
Sumona Bhattacharya1, Yilun Koethe2, Alexander Ling3
1Digestive 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.
Insights
Gastrointestinal abnormalities are common in Chronic Granulomatous Disease (CGD). CT scans showing bowel wall thickening in CGD patients correlate with inflammation found during endoscopy and histopathology.
Area of Science:
- Immunology
- Gastroenterology
- Radiology
Background:
- Chronic Granulomatous Disease (CGD) is a rare primary immunodeficiency.
- CGD can lead to gastrointestinal (GI) complications, including inflammatory bowel disease.
- Radiographic findings in CGD patients with GI complications are not well-described.
Purpose of the Study:
- To determine the frequency and spectrum of GI abnormalities on CT in CGD patients.
- To assess if CT findings predict endoscopic or histopathologic inflammation.
- To correlate radiographic findings with clinical outcomes in CGD.
Main Methods:
- Retrospective review of 141 CGD patients' CT scans (1988-2011).
- Analysis of GI abnormalities, specifically wall thickening, on CT.
- Comparison of CT findings with endoscopic and histopathologic data from 20 patients.
Main Results:
- GI wall thickening was observed on CT in 61% of CGD patients.
- A significant correlation was found between CT-detected wall thickening and endoscopic inflammation (p=0.035).
- CT findings also significantly correlated with histopathologic evidence of inflammation (p=0.02).
Conclusions:
- GI abnormalities are frequently detected by CT in CGD patients.
- Bowel wall thickening on CT is a reliable indicator of underlying GI inflammation.
- These findings can guide more targeted endoscopic evaluation and biopsies in CGD.
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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