Colitis in chronic granulomatous disease

Background-Involvement of the gut in chronic granulomatous disease (CGD) ha s been previously described and colitis highlighted. However, the nature an d histopathology of the colitis are unclear and have been thought to be non -specific or similar to Crohn's disease. Methods-Seven patients with CGD, suffering from gastrointestinal symptoms w ere prospectively studied. Results-All patients had anaemia; other symptoms were failure to thrive (5/ 7) and diarrhoea (5/7). Most had microcytic anaemia (5/7), increased platel ets (7/7), and increased erythrocyte sedimentation rate (6/6). Endoscopical ly there was a friable erythematous mucosa in 6/7. The histological feature s present in all patients consisted of a colitis with paucity of neutrophil s, increased numbers of eosinophils, eosinophilic crypt abscesses, pigmente d macrophages, and nuclear debris. In some granulomas were present (2/7). Conclusions-Colitis is a common cause of gastrointestinal symptoms in CGD a nd is caused by a non-infective inflammatory process. The histology has spe cific features, which are distinctive from those seen in Crohn's disease.