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Resolution of hepatic abscess after interferon gamma in chronic granulomatous disease
R A Hague1, E J Eastham, R E Lee
1Department of Paediatric Immunology, Newcastle General Hospital, Newcastle upon Tyne.
Abstract:
Recombinant interferon gamma has been used prophylactically in children with chronic granulomatous disease, but its role in the treatment of acute infective episodes has not been defined. A 3 year old boy presented with multiple candidal liver abscesses and was given intravenous antifungal treatment and he showed initial improvement. After six weeks his erythrocyte sedimentation rate and C reactive protein remained raised, and a computed tomogram showed a single abscess in the left lobe of the liver from which pus was drained and Staphylococcus aureus isolated. During the next eight months the abscess persisted despite appropriate intravenous antibiotics and percutaneous drainage. Subphrenic extension precluded definitive surgery. Nine months after initial presentation recombinant interferon gamma 0.05 mg/m2 intravenously was commenced three times a week. Complete resolution occurred within two months. It is concluded that interferon gamma is useful in treating infective episodes, and further study of the use of prophylactic antimicrobial treatment and intermittent interferon gamma during acute episodes is now required.
Insights
Recombinant interferon gamma effectively treated a persistent liver abscess in a child with chronic granulomatous disease. This suggests interferon gamma may be a valuable treatment for acute infections in such patients.
Area of Science:
- Immunology
- Pediatric Infectious Diseases
Background:
- Recombinant interferon gamma is used prophylactically in chronic granulomatous disease (CGD).
- Its efficacy in treating acute infections in CGD patients is not well-established.
Observation:
- A 3-year-old boy with CGD presented with multiple liver abscesses.
- Despite antifungal treatment, antibiotics, and drainage, a persistent Staphylococcus aureus liver abscess developed.
- Subphrenic extension prevented surgical intervention.
Findings:
- Intravenous recombinant interferon gamma (0.05 mg/m2 thrice weekly) was administered.
- Complete resolution of the liver abscess occurred within two months of treatment.
Implications:
- Interferon gamma shows promise as a therapeutic agent for acute infective episodes in CGD.
- Further research is warranted on prophylactic antimicrobial and intermittent interferon gamma use during acute phases of CGD.