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. 1993 Oct;69(4):443–445. doi: 10.1136/adc.69.4.443

Resolution of hepatic abscess after interferon gamma in chronic granulomatous disease.

R A Hague 1, E J Eastham 1, R E Lee 1, A J Cant 1
PMCID: PMC1029553  PMID: 8259876

Abstract

Recombinant interferon gamma has been used prophylactically in children with chronic granulomatous disease, but its role in the treatment of acute infective episodes has not been defined. A 3 year old boy presented with multiple candidal liver abscesses and was given intravenous antifungal treatment and he showed initial improvement. After six weeks his erythrocyte sedimentation rate and C reactive protein remained raised, and a computed tomogram showed a single abscess in the left lobe of the liver from which pus was drained and Staphylococcus aureus isolated. During the next eight months the abscess persisted despite appropriate intravenous antibiotics and percutaneous drainage. Subphrenic extension precluded definitive surgery. Nine months after initial presentation recombinant interferon gamma 0.05 mg/m2 intravenously was commenced three times a week. Complete resolution occurred within two months. It is concluded that interferon gamma is useful in treating infective episodes, and further study of the use of prophylactic antimicrobial treatment and intermittent interferon gamma during acute episodes is now required.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Chusid M. J. Pyogenic hepatic abscess in infancy and childhood. Pediatrics. 1978 Oct;62(4):554–559. [PubMed] [Google Scholar]
  2. Ezekowitz R. A., Dinauer M. C., Jaffe H. S., Orkin S. H., Newburger P. E. Partial correction of the phagocyte defect in patients with X-linked chronic granulomatous disease by subcutaneous interferon gamma. N Engl J Med. 1988 Jul 21;319(3):146–151. doi: 10.1056/NEJM198807213190305. [DOI] [PubMed] [Google Scholar]
  3. Ezekowitz R. A., Orkin S. H., Newburger P. E. Recombinant interferon gamma augments phagocyte superoxide production and X-chronic granulomatous disease gene expression in X-linked variant chronic granulomatous disease. J Clin Invest. 1987 Oct;80(4):1009–1016. doi: 10.1172/JCI113153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Forrest C. B., Forehand J. R., Axtell R. A., Roberts R. L., Johnston R. B., Jr Clinical features and current management of chronic granulomatous disease. Hematol Oncol Clin North Am. 1988 Jun;2(2):253–266. [PubMed] [Google Scholar]
  5. Goddard E. A., Hughes E. J., Duys P. J., Hoffman E. B., Beatty D. W. Treatment of chronic granulomatous disease with recombinant gamma interferon. S Afr Med J. 1992 Jan 18;81(2):81–83. [PubMed] [Google Scholar]
  6. Johnston H. C., Shigeoka A. O., Hurley D. C., Pysher T. J. Nocardia pneumonia in a neonate with chronic granulomatous disease. Pediatr Infect Dis J. 1989 Aug;8(8):526–528. doi: 10.1097/00006454-198908000-00011. [DOI] [PubMed] [Google Scholar]
  7. Kolb H., Kolb-Bachofen V. Nitric oxide: a pathogenetic factor in autoimmunity. Immunol Today. 1992 May;13(5):157–160. doi: 10.1016/0167-5699(92)90118-Q. [DOI] [PubMed] [Google Scholar]
  8. Mouy R., Seger R., Bourquin J. P., Veber F., Blanche S., Griscelli C., Fischer A. Interferon gamma for chronic granulomatous disease. N Engl J Med. 1991 Nov 21;325(21):1516–1517. doi: 10.1056/NEJM199111213252115. [DOI] [PubMed] [Google Scholar]
  9. Mulholland M. W., Delaney J. P., Simmons R. L. Gastrointestinal complications of chronic granulomatous disease: surgical implications. Surgery. 1983 Oct;94(4):569–575. [PubMed] [Google Scholar]
  10. Murray H. W. Interferon-gamma, the activated macrophage, and host defense against microbial challenge. Ann Intern Med. 1988 Apr;108(4):595–608. doi: 10.7326/0003-4819-108-4-595. [DOI] [PubMed] [Google Scholar]
  11. Mühlebach T. J., Gabay J., Nathan C. F., Erny C., Dopfer G., Schroten H., Wahn V., Seger R. A. Treatment of patients with chronic granulomatous disease with recombinant human interferon-gamma does not improve neutrophil oxidative metabolism, cytochrome b558 content or levels of four anti-microbial proteins. Clin Exp Immunol. 1992 May;88(2):203–206. doi: 10.1111/j.1365-2249.1992.tb03062.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Nathan C. F., Horowitz C. R., de la Harpe J., Vadhan-Raj S., Sherwin S. A., Oettgen H. F., Krown S. E. Administration of recombinant interferon gamma to cancer patients enhances monocyte secretion of hydrogen peroxide. Proc Natl Acad Sci U S A. 1985 Dec;82(24):8686–8690. doi: 10.1073/pnas.82.24.8686. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Newburger P. E., Ezekowitz R. A., Whitney C., Wright J., Orkin S. H. Induction of phagocyte cytochrome b heavy chain gene expression by interferon gamma. Proc Natl Acad Sci U S A. 1988 Jul;85(14):5215–5219. doi: 10.1073/pnas.85.14.5215. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Pastakia B., Shawker T. H., Thaler M., O'Leary T., Pizzo P. A. Hepatosplenic candidiasis: wheels within wheels. Radiology. 1988 Feb;166(2):417–421. doi: 10.1148/radiology.166.2.3275982. [DOI] [PubMed] [Google Scholar]
  15. Phillips P., Forbes J. C., Speert D. P. Disseminated infection with Pseudallescheria boydii in a patient with chronic granulomatous disease: response to gamma-interferon plus antifungal chemotherapy. Pediatr Infect Dis J. 1991 Jul;10(7):536–539. doi: 10.1097/00006454-199107000-00011. [DOI] [PubMed] [Google Scholar]
  16. Sechler J. M., Malech H. L., White C. J., Gallin J. I. Recombinant human interferon-gamma reconstitutes defective phagocyte function in patients with chronic granulomatous disease of childhood. Proc Natl Acad Sci U S A. 1988 Jul;85(13):4874–4878. doi: 10.1073/pnas.85.13.4874. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Segal A. W., Harper A. M., Garcia R. C., Merzbach D. The action of cells from patients with chronic granulomatous disease on Staphylococcus aureus. J Med Microbiol. 1982 Nov;15(4):441–449. doi: 10.1099/00222615-15-4-441. [DOI] [PubMed] [Google Scholar]
  18. Skibber J. M., Lotze M. T., Garra B., Fauci A. Successful management of hepatic abscesses by percutaneous catheter drainage in chronic granulomatous disease. Surgery. 1986 May;99(5):626–630. [PubMed] [Google Scholar]
  19. Woodman R. C., Erickson R. W., Rae J., Jaffe H. S., Curnutte J. T. Prolonged recombinant interferon-gamma therapy in chronic granulomatous disease: evidence against enhanced neutrophil oxidase activity. Blood. 1992 Mar 15;79(6):1558–1562. [PubMed] [Google Scholar]
  20. Yang K. D., Hill H. R. Neutrophil function disorders: pathophysiology, prevention, and therapy. J Pediatr. 1991 Sep;119(3):343–354. doi: 10.1016/s0022-3476(05)82044-x. [DOI] [PubMed] [Google Scholar]

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