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  4. Neonatal Manifestations of Chronic Granulomatous Disease: MAS/HLH and Necrotizing Pneumonia as Unusual Phenotypes and Review of the Literature
 
review article

Neonatal Manifestations of Chronic Granulomatous Disease: MAS/HLH and Necrotizing Pneumonia as Unusual Phenotypes and Review of the Literature

Marzollo, Antonio
•
Conti, Francesca
•
Rossini, Linda
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2022
Journal Of Clinical Immunology

Chronic granulomatous disease (CGD) is a rare inborn error of immunity (IEI), characterized by a deficient phagocyte killing due to the inability of NADPH oxidase to produce reactive oxygen species in the phagosome. Patients with CGD suffer from severe and recurrent infections and chronic inflammatory disorders. Onset of CGD has been rarely reported in neonates and only as single case reports or small case series. We report here the cases of three newborns from two different kindreds, presenting with novel infectious and inflammatory phenotypes associated with CGD. A girl with CYBA deficiency presented with necrotizing pneumonia, requiring a prolonged antibiotic treatment and resulting in fibrotic pulmonary changes. From the second kindred, the first of two brothers developed a fatal Burkholderia multivorans sepsis and died at 24 days of life. His younger brother had a diagnosis of CYBB deficiency and presented with Macrophage Activation Syndrome/Hemophagocytic Lympho-Histiocytosis (MAS/HLH) without any infection, that could be controlled with steroids. We further report the findings of a review of the literature and show that the spectrum of microorganisms causing infections in neonates with CGD is similar to that of older patients, but the clinical manifestations are more diverse, especially those related to the inflammatory syndromes. Our findings extend the spectrum of the clinical presentation of CGD to include unusual neonatal phenotypes. The recognition of the very early, potentially life-threatening manifestations of CGD is crucial for a prompt diagnosis, improvement of survival and reduction of the risk of long-term sequelae.

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Type
review article
DOI
10.1007/s10875-021-01159-4
Web of Science ID

WOS:000713075100001

Author(s)
Marzollo, Antonio
Conti, Francesca
Rossini, Linda
Rivalta, Beatrice
Leonardi, Lucia
Tretti, Caterina
Tosato, Francesca
Chiriaco, Maria
Ursu, Giorgiana Madalina
Natalucci, Cristina Tea
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Date Issued

2022

Publisher

SPRINGER/PLENUM PUBLISHERS

Published in
Journal Of Clinical Immunology
Volume

42

Start page

299

End page

311

Subjects

Immunology

•

newborn

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hlh

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mas

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necrotizing pneumonia

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cgd

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cybb

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cyba

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macrophage activation syndrome

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term-follow-up

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hemophagocytic lymphohistiocytosis

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inflammatory manifestations

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diagnosis

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children

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transplantation

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experience

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infant

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involvement

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
UPFELLAY  
Available on Infoscience
November 20, 2021
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/183158
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