慢性肉芽肿性疾病
医学
原发性免疫缺陷
免疫学
炎症性肠病
吞噬细胞
免疫缺陷
耐火材料(行星科学)
疾病
免疫系统
内科学
天体生物学
物理
作者
Marco Antonio Yamazaki‐Nakashimada,E. Richard Stiehm,Dino Pietropaolo-Cienfuegos,Víctor Manuel Hernández-Bautista,Francisco Espinosa-Rosales
标识
DOI:10.1016/s1081-1206(10)60023-3
摘要
Background Chronic granulomatous disease (CGD) is a primary phagocyte immunodeficiency. It is often accompanied by an exuberant and aberrant inflammatory response, with granulomata and obstruction of the gastrointestinal and genitourinary tracts and inflammatory bowel disease. Although corticosteroids are successful in managing the obstructive and inflammatory disorders of CGD, they are not ordinarily used for the management of infection because of the possibility of further compromising the patient's immune system. Objectives To discuss the pros and cons of the use of corticosteroids for the treatment of infections in CGD. Methods We describe 2 patients with CGD and refractory infections who were successfully treated with systemic corticosteroids in addition to antimicrobial agents. We also review the medical literature in which corticosteroids have been used for CGD infection. Results Our cases add to 3 other reports in which antibiotics and corticosteroids were used successfully in patients with CGD. However, in the presence of a potential pathogen, notably, aspergilla, corticosteroids may mask or favor dissemination of the fungus, especially in adults. Conclusions Corticosteroids may play an important adjunctive role in CGD refractory infections. Chronic granulomatous disease (CGD) is a primary phagocyte immunodeficiency. It is often accompanied by an exuberant and aberrant inflammatory response, with granulomata and obstruction of the gastrointestinal and genitourinary tracts and inflammatory bowel disease. Although corticosteroids are successful in managing the obstructive and inflammatory disorders of CGD, they are not ordinarily used for the management of infection because of the possibility of further compromising the patient's immune system. To discuss the pros and cons of the use of corticosteroids for the treatment of infections in CGD. We describe 2 patients with CGD and refractory infections who were successfully treated with systemic corticosteroids in addition to antimicrobial agents. We also review the medical literature in which corticosteroids have been used for CGD infection. Our cases add to 3 other reports in which antibiotics and corticosteroids were used successfully in patients with CGD. However, in the presence of a potential pathogen, notably, aspergilla, corticosteroids may mask or favor dissemination of the fungus, especially in adults. Corticosteroids may play an important adjunctive role in CGD refractory infections.
科研通智能强力驱动
Strongly Powered by AbleSci AI