Treatment of Chronic Granulomatous Disease with Gut or Urinary Tract Obstruction due to Granulomatous Inflammation
Clinical scenario
People with chronic granulomatous disease (CGD) are at risk of developing obstruction of the gut or urinary tract caused by granulomatous inflammation. This can present as difficulty swallowing (oesophageal obstruction), vomiting (gastric outlet obstruction), abdominal pain (bowel obstruction), or difficulty passing urine — including ureteral obstruction leading to hydronephrosis.
Treatment approach
First-line protocol
An anti-inflammatory therapeutic class is the mainstay of management for these obstructive complications. Critically, an infectious cause must be excluded before any treatment is initiated — the full protocol specifies the required pre-treatment evaluation and the complete clinical decision pathway.
Specific agents, sequencing, and monitoring criteria are detailed in the full protocol.
Treatment goal
Prompt resolution of the obstruction.
References
- People with CGD are at risk of getting obstruction of the gut or urinary tract due to granulomatous inflammation.
- This may manifest as a difficulty in swallowing (obstruction of the oesophagus), vomiting (gastric outlet obstruction), abdominal pain (obstruction of the bowel) or difficulty in passing urine (obstruction of the ureter).
- All of these conditions respond promptly to steroids but it is essential to rule out an infectious cause before starting steroid therapy.
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