To the Editor:
Chronic granulomatous disease (CGD) is a rare genetic disorder of phagocyte oxidative metabolism. In addition to infectious complications, granulomatous lesions can involve the gastrointestinal (GI) tract and can mimic ulcerative colitis or Crohn's disease. 1,2 Crohn's-like manifestations can include oral ulcerations, bowel obstruction, enteritis, colitis, fistulae, abscess, and perianal disease. 3 The inflammatory bowel disease in this setting may be severe and cause significant morbidity and adversely impact patients' quality of life.
Narrow band imaging (NBI) is a new technology that uses 2 specific wavelengths of light, 1 blue and 1 green, to accentuate vascular structures and provide high-contrast endoscopic images of mucosal surfaces. The use of NBI is rapidly expanding in the evaluation of both upper and lower GI diseases; however, the use of NBI in CGD has not previously been reported. Herein we provide the first report on the use of NBI in CGD.
A 15-year-old boy with CGD and a history of CGD-associated colitis in clinical remission for over 4 years on low-dose prednisone (5 mg per day) presented with hyperglycemia and growth delay. Colonoscopy was performed to evaluate subclinical colitis prior to a planned prednisone taper.