Treatment with intralesional granulocyte instillations and interferon-gamma for a patient with chronic granulomatous disease and multiple hepatic abscesses.
We present the case of a 16-year-old girl with p22-deficient chronic granulomatous disease in whom multiple hepatic abscesses secondary to Staphylococcus aureus infection developed. Infection persisted despite extensive surgery and aggressive antibiotic therapy. Conventional intravenous granulocyte transfusions were not tolerated because of the development of alloantibodies to HLA. Treatment with interferon-gamma and intralesional granulocyte infusions was associated with dramatic clinical and radiographic improvement. No morbidity was associated with this therapy. To our knowledge, this is the first report of treatment with intralesional granulocyte instillations. Intralesional granulocyte instillation in association with interferon-gamma administration may result in clinical improvement in the conditions of patients with chronic granulomatous disease and hepatic abscesses for whom conventional therapy has failed.
Lekstrom-Himes
J A
JA
National Institute of Allergy and Infectious Diseases, Department of Transfusion Medicine, Warren Grant Magnuson Clinical Center, Bethesda, Maryland.
Holland
S M
SM
DeCarlo
E S
ES
Miller
J
J
Leitman
S F
SF
Chang
R
R
Baker
A R
AR
Gallin
J I
JI
D000293:Adolescent; D000900:Anti-Bacterial Agents; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006098:Granulocytes; D006105:Granulomatous Disease, Chronic / Q000150:complications* / Q000628:therapy*; D006801:Humans; D015552:Injections, Intralesional; D007371:Interferon-gamma / Q000627:therapeutic use*; D017708:Leukocyte Transfusion / Q000379:methods*; D008100:Liver Abscess / Q000150:complications* / Q000628:therapy*; D013203:Staphylococcal Infections / Q000150:complications* / Q000628:therapy*
D000900:Anti-Bacterial Agents; D007371:Interferon-gamma