The nature of colitis in chronic granulomatous disease

Background—Involvement of the gut in chronic granulomatous disease (CGD) has been previously described and colitis highlighted. However, the nature and 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, suf-fering from gastrointestinal symptoms were 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 platelets (7/7), and increased erythrocyte sedimentation rate (6/6). Endoscopically there was a friable erythematous mucosa in 6/7. The histological features present in all patients consisted of a colitis with paucity of neutrophils, increased numbers of eosi-nophils, eosinophilic crypt abscesses, pig-mented macrophages, and nuclear debris. In some granulomas were present (2/7). Conclusions—Colitis is a common cause of gastrointestinal symptoms in CGD and is caused by a non-infective inflammatory process. The histology has specific fea-tures, which are distinctive from those seen in Crohn’s disease