This page is for healthcare professionals treating patients with chronic granulomatous disease.
This page is for HCPs treating patients with CGD.

Chronic granulomatous disease (CGD) affects multiple organs

Knowing what to look for can aid in the diagnosis of chronic granulomatous disease (CGD). CGD affects multiple organ systems, particularly any major viscus organ. Granulomas tend to form at sites of hollow organs, like the bladder or gastrointestinal (GI) tract.1

Most frequent sites of infection and common infectious and inflammatory complications1

Diagram of CGD symptom locations, including lymph nodes, liver, colon, bone, lung, stomach, urinary tract, skin

Look for the pathogens that may indicate CGD1-8

Patients with primary immunodeficiencies present frequently with chronic and/or recurrent infections caused by a broad array of pathogens and do so early in life. The large majority of severe infections in patients with CGD in North America are caused by a particular group of organisms, both bacterial and fungal.

Top pathogens and common presentation associated with CGD

Fungal

Aspergillus species icon
Aspergillus species
Common presentation: pneumonia, lymphadenitis, osteomyelitis, brain abscess
Candida species icon
Candida species
Common presentation: sepsis, soft tissue infection, liver abscess

Bacterial

Nocardia species icon
Nocardia species
Common presentation: pneumonia, osteomyelitis, brain abscess
Serratia marcescens icon
Serratia marcescens
More common presentation: osteomyelitis, soft tissue infections
Less common presentation: pneumonia, sepsis
Burkholderia (pseudomonas) cepacia complex icon
Burkholderia (pseudomonas) cepacia complex
Common presentation: pneumonia, sepsis
Klebsiella species icon
Klebsiella species
Common presentation: pneumonia, skin infections, lymphadenitis
Staphylococcus aureus icon
Staphylococcus aureus
Common presentation: soft tissue infections, lymphadenitis, liver abscess, perirectal abscess, osteomyelitis, pneumonia, sepsis

Recognize your IBD patients who may have CGD

GI inflammation is a common manifestation of CGD. About 50% of CGD patients experience chronic GI inflammation, and GI inflammation precedes a CGD diagnosis in up to 17% of patients.9

  • The GI tract is the most frequently affected organ for the development of granulomatous inflammatory lesions in CGD10
  • Similarities with inflammatory bowel disease (IBD) may lead to misdiagnosis
  • In a large study of 98 patients with CGD, 95% had at least subclinical levels of colitis based on characteristic histologic features10
  • Patients may present with diarrhea, abdominal pain, constipation, weight loss, failure to thrive, presence of granuloma, and perianal and liver abscesses1,9

Get information about CGD and ACTIMMUNE® (Interferon gamma-1b) sign up button

References: 1. Leiding JW, Holland SM. Chronic granulomatous disease. In: Pagon RA, Adam MP, Ardinger HH, et al, eds. GeneReviews. Seattle, WA: University of Washington, Seattle; 1993-2016. 2. Bonilla FA, Khan DA, Ballas ZK, et al. Practice parameter for the diagnosis and management of primary immunodeficiency. J Allergy Clin Immunol. 2015;136(5):1186-1205.e1-e78. 3. Leiding JW, Malech HL, Holland SM. Chronic granulomatous disease. Clinical Focus on Primary Immunodeficiencies. 2013;15:1-9. 4. Song E, Jaishankar GB, Saleh H, Jithpratuck W, Sahni R, Krishnaswamy G. Chronic granulomatous disease: a review of the infectious and inflammatory complications. Clin Mol Allergy. 2011;9(1):10. 5. van den Berg JM, van Koppen E, Ahlin A, et al. Chronic granulomatous disease: the European experience. PLoS One. 2009;4(4):e5234. 6. Chronic granulomatous disease. BMJ Best Practice website. http://bestpractice.bmj.com/best-practice/verify-user-north-american-access.html. Updated July 1, 2016. Accessed January 10, 2017. 7. Marciano BE, Spalding C, Fitzgerald A, et al. Common severe infections in chronic granulomatous disease. Clin Infect Dis. 2015;60(8):1176-1183. 8. Bortoletto P, Lyman K, Camacho A, Fricchione M, Khanolkar A, Katz BZ. Chronic granulomatous disease: a large, single-center US experience. Pediatr Infect Dis J. 2015;34(10):1110-1114. 9. Alimchandani M, Lai J-P, Aung PP, et al. Gastrointestinal histopathology in chronic granulomatous disease: a study of 87 patients. Am J Surg Pathol. 2013;37(9):1365-1372. 10. Magnani A, Brosselin P, Beauté, et al. Inflammatory manifestations in a single-center cohort of patients with chronic granulomatous disease. J Allergy Clin Immunol. 2014;134(3):655-662.e8.

Important Safety Information

INDICATIONS AND USAGE

ACTIMMUNE® (Interferon gamma-1b) is indicated:

Important Safety Information

INDICATIONS AND USAGE

ACTIMMUNE® (Interferon gamma-1b) is indicated:

  • For reducing the frequency and severity of serious infections associated with Chronic Granulomatous Disease
  • For delaying time to disease progression in patients with severe, malignant osteopetrosis

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • In patients who develop or have known hypersensitivity to interferon-gamma, E coli-derived products, or any component of the product

WARNINGS AND PRECAUTIONS

  • ACTIMMUNE should be used with caution in patients with:
    • Pre-existing cardiac conditions, including ischemia, congestive heart failure, or arrhythmia
    • Seizure disorders or compromised central nervous system function; reduce dose or discontinue
    • Myelosuppression, or receiving other potentially myelosuppressive agents; consider dose reduction or discontinuation of therapy
    • Severe renal insufficiency
    • Age <1 year

  • Monitoring:
    • Patients begun on ACTIMMUNE before age 1 year should receive monthly assessments of liver function. If severe hepatic enzyme elevations develop, ACTIMMUNE dosage should be modified
    • Monitor renal function regularly when administering ACTIMMUNE in patients with severe renal insufficiency; accumulation of interferon gamma-1b may occur with repeated administration. Renal toxicity has been reported in patients receiving ACTIMMUNE

  • Pregnancy, Lactation, and Fertility:
    • ACTIMMUNE should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus
    • Use of ACTIMMUNE by lactating mothers is not recommended. ACTIMMUNE or nursing should be discontinued dependent on the importance of the drug to the mother
    • Long-term effects of ACTIMMUNE on fertility are not known

DRUG INTERACTIONS

  • Concomitant use of drugs with neurotoxic, hematotoxic, or cardiotoxic effects may increase the toxicity of interferons
  • Avoid simultaneous administration of ACTIMMUNE with other heterologous serum protein or immunological preparations (eg, vaccines)

ADVERSE REACTIONS

  • The most common adverse experiences occurring with ACTIMMUNE therapy are “flu-like” symptoms such as fever, headache, chills, myalgia, or fatigue, which may decrease in severity as treatment continues, and may be minimized by bedtime administration of ACTIMMUNE. Acetaminophen may be used to prevent or partially alleviate the fever and headache
  • Isolated cases of acute serious hypersensitivity reactions have been observed in patients receiving ACTIMMUNE
  • Reversible neutropenia, thrombocytopenia, and elevations of AST and/or ALT have been observed during ACTIMMUNE therapy
  • At doses 10 times greater than the weekly recommended dose, ACTIMMUNE may exacerbate pre-existing cardiac conditions, or may cause reversible neurological effects such as decreased mental status, gait disturbance, and dizziness