Chest Infections: Chest Infections |

Chest Radiographic Manifestations of Chronic Granulomatous Disease in Children FREE TO VIEW

Qiong Yao, PhD; Xi-hong Hu, PhD; Zhong-wei Qiao, PhD
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Children's Hospital of Fudan University, Shanghai, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A80. doi:10.1016/j.chest.2016.02.085
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SESSION TITLE: Chest Infections

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: The purpose of this research was to describe the thoracic CT features of chronic granulomatous disease in children.

METHODS: We retrospectively summarized the CT findings in 18 children diagnosed with chronic granulomatous disease in a single-center during five episodes of lower respiratory tract infection from November 2004 to January 2015.

RESULTS: Most patients onset in the infantile period and presented with respiratory infections. Four patients were also identified with tuberculosis and 5 with fungal inflammation. CT findings included areas of consolidation (77.8%), ground-glass opacities (77.8%), randomly nodules and masses (77.8%), reticulation (83.3%), tree-in-bud opacities (83.3%), intralobular septal thickening (72.2%), areas of decreased attenuation and vascularity (61.1%), pulmonary scarring (72.2%), focal emphysemia (38.9%), bronchiectasis (38.9%), pleural effusion (72.2%). Cavities in masses and nodules could be found in 4 patients (22.2%), while 7 patients (38.9%) had necrosis in masses and consolidation. Fourteen patients (77.8%) showed mediastinal and/or hilar lymphadenopathy, especially 7 (38.9%) with ipsilateral axillary limph nodes enlargement and calcification after Bacille Calmette-Guerin (BCG) vaccine. Three patients (16.7%) demonstrated pulmonary artery enlargement, among them 1 (5.6%) with severe interstitial fibrosis presented with heart failure. Chest wall infection was found in 1 patient (5.6%), presenting osteomyelitis of the ribs and chest wall soft tissue invasion. All the laboratory exams were reviewed and CT findings could be associated with the infection of tuberculosis and fungus.

CONCLUSIONS: The most prominent radiologic findings of chronic granulomatous disease include focal consolidation, multiple nodules and masses, extensive intestinal disease, cavitary lesions, and mediastinal and/or hilar lymph nodes enlargement.

CLINICAL IMPLICATIONS: Ipsilateral axillary lymphadenopathy with calcification after BCG vaccine has certain particularity for clinical diagnosis. Some patients will progress into pulmonary heart disease.

DISCLOSURE: The following authors have nothing to disclose: Qiong Yao, Xi-hong Hu, Zhong-wei Qiao





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