Chronic Granulomatous Disease Follow-up

  • Author: Roman Janusz Nowicki, MD, PhD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 4, 2012
 

Further Outpatient Care

  • Skin hygiene is an important element of further outpatient care for chronic granulomatous disease (CGD). The skin should be washed twice daily with a disinfectant soap.
  • The fingernails should be cut short.
  • The patient should be monitored for the results of antibacterial and antifungal prophylaxis.
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Deterrence/Prevention

  • Chronic granulomatous disease in adults may be more common than previously assumed.
  • Because timely treatment, infection prophylaxis, and genetic counseling for affected families are possible, chronic granulomatous disease should be excluded in any patient with unexplained infections or granulomas.
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Complications

  • Invasive aspergillosis and candidiasis may occur.
    • Patients with chronic granulomatous disease can be sensitized to Aspergillus species.
    • Allergic bronchopulmonary aspergillosis can develop.
  • Gastrointestinal complications include the following:
    • Enteritis and/or colitis
    • Crohn disease
    • Gastric outlet obstruction
    • Chronic gastrointestinal inflammation
  • Rheumatologic disorders include the following:
    • Discoid lupus erythematosus
    • Systemic lupus erythematosus
    • Raynaud syndrome
    • Nodular vasculitis
    • Juvenile rheumatoid arthritis
    • Immune-mediated thrombocytopenia
  • Other complications include the following:
    • Chorioretinitis
    • Obstruction of the urinary tract
    • Severe aphthous stomatitis
    • Granulomatous cheilitis
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Prognosis

  • The long-term survival of patients in whom symptoms appear after they are aged 1 year is significantly better than that of patients whose illness starts in infancy.
  • Survival rates are variable but improving; approximately 50% of patients survive to age 30-40 years.
  • Infections are less common in adults than in children, but the propensity for severe life-threatening bacterial infections persists throughout life.
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Patient Education

  • Good hygiene of the skin is an important element of treatment because the skin is a common portal of entry in serious infections.
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Contributor Information and Disclosures
Author

Roman Janusz Nowicki, MD, PhD  Professor, Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Poland

Roman Janusz Nowicki, MD, PhD is a member of the following medical societies: American Academy of Dermatology, European Academy of Dermatology and Venereology, and International Society for Human and Animal Mycology

Disclosure: Nothing to disclose.

Specialty Editor Board

Jacek C Szepietowski, MD, PhD  Professor, Vice-Head, Department of Dermatology, Venereology and Allergology, Wroclaw Medical University; Director of the Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Poland

Disclosure: Stiefel GSK Company Salary Employment; Orfagen Consulting fee Consulting; Maruho Consulting fee Consulting; Astellas Consulting fee Consulting; Abbott Consulting fee Consulting; Leo Pharma Consulting fee Consulting

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

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