CGD-Associated Colitis After 5-ASA Agents Have Failed to Achieve Remission

Colitis is a recognised inflammatory complication of chronic granulomatous disease (CGD). It can closely resemble Crohn's disease, with diarrhoea, weight loss, failure to thrive, and perianal disease among the presenting features. When first-line therapy does not induce or sustain remission, a structured escalation approach is needed.

Previous treatment — failure condition

First-line 5-ASA agents (Sulphasalazine or Mesalazine) were used with the goal of inducing and maintaining remission of CGD-associated colitis. Escalation to this protocol is indicated when those goals were not achieved.

Next-line approach — partial overview

This protocol involves immunosuppressive therapy, including steroids, used carefully and in close coordination with a specialist centre. Further agent selection and sequencing are detailed in the full regimen.

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References

Colitis is probably the most common significant inflammatory complication of CGD.
A CGD associated colitis can be misdiagnosed as Crohn's disease where symptoms such as diarrhoea, weight loss, failure to thrive and perianal disease constitute the initial findings.
Steroids, and other immunosuppressive agents, such as Azathioprine, may be indicated where 5-ASA has failed to induce/maintain remission.

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