CGD is an inherited condition of the immune system. It's known as a "primary immunodeficiency."
Children inherit the gene for the CGD from their parents, who may not have any symptoms.
Most often:
- Boys who get this disease inherit it from only the mother.
- Girls inherit CGD when both parents carry the gene.
The body's immune system fights infections and anything it sees as foreign invaders to the body.
A healthy immune system creates masses of immune cells called "granulomas" at infection sites. Within these granulomas are immune cells called neutrophils that make hydrogen peroxide to fight infection. As the infection clears, the granulomas go away.
In CGD, neutrophils aren't able to make the hydrogen peroxide our bodies need to fight invaders like bacteria or fungus.
Since the neutrophils can't control the bacteria or fungus, they can spread causing severe infections. The body realizes the immune system isn't clearing the infection, so the granulomas keep growing.
How Common Is CGD?
CGD is rare. Doctors find it in only 4 or 5 people per million.
CGD is more common in boys than girls.
CGD Symptoms
Depending on how severe CGD is, children may have symptoms before age one or not until later in childhood.
Symptoms of CGD are much the same as symptoms of other childhood illnesses. But the symptoms of CGD may be more severe and last longer.
CGD symptoms are:
- Respiratory infections that keep coming back, including sinus and lung infections and recurrent pneumonia.
- Skin infections and swelling that don't respond well to treatment.
- Swollen lymph nodes or infections.
- Liver problems.
- Bone infections.
- Belly pain and diarrhea.
Complications of CGD
Children with primary immune deficiencies like CGD are:
- More prone than others to getting infections.
- Slower to clear infections from their bodies.
- At risk for recurrent pneumonia that can cause permanent damage to the lungs, causing severe health problems into adulthood.
Granulomas may also form on bones, in the brain, and in the intestinal and urinary tract, causing blockages.
How Do You Diagnose CGD?
Doctors diagnose CGD through blood tests. Testing for certain immune markers in the blood lets us see how well the immune system is working.
Your child may also need chest x-rays and other body scans. These tests will let us see if CGD has damaged the lungs or other organs and bones.
CGD Treatment
The goal of treating CGD is to control the symptoms.
Children with CGD may need aggressive treatment for their infections. Sometimes, doctors prescribe antibiotics to prevent infections even when a child doesn't have any.
Children whose disease is more severe may need a bone marrow or cord blood transplant to replace their immune system.
If CGD causes severe health problems — such as lung disease or lung failure — a transplant my benefit your child.
Hillman Center for Pediatric Transplant has the only program in the world that offers tandem lung and bone marrow transplants.
We also pioneered a reduced-intensity bone marrow transplant program. It helps reduce the negative effects a bone marrow or stem cell transplant has on the body's organs.
Because transplants are high-risk treatments, your child may need to remain on lifelong medication.
Paul Szabolcs, MD
Chief, Bone Marrow Transplantation and Cellular Therapies
Dr. Szabolcs is a pioneer in reduced-toxicity/intensity unrelated donor cord blood transplant for inborn errors of immunity. He's the first to prove the feasibility of sequential lung and bone marrow transplantation from the same unrelated deceased donor.
Your Child's CGD Consult and Care: What to Expect
If a doctor diagnosed your child with CGD, we want you to know you're not alone. The Center for Rare Disease Therapy (CRDT) at UPMC Children's Hospital of Pittsburgh is here to help.
To make an appointment for your child or refer a patient for CGD care, contact us by:
Here’s what you can expect when you come to us for your child's first CGD consult.
What should I expect at my child's first visit for CGD care?
You can expect your first visit to take from 4 to 6 hours.
Your child will receive a complete assessment from one of the center's doctors.
Your doctor will make or confirm a CGD diagnosis and find out how much the disease has progressed.
Because we work as a team at the CRDT, other doctors and staff might see your child during your visit.
These may include a:
- Doctor trained in infectious diseases.
- Blood disorders doctor.
- GI tract doctor.
- Hearing specialist.
- Bone marrow transplant doctor.
What are the next steps after my child's visit to the Center for Rare Disease Therapy?
Members of your child's CGD care team will talk with you about:
- Likely next steps for your child in the near future.
- Options for treating your child's CGD.
- Ways to care for your child at home to help improve his or her quality of life.
If a blood or bone marrow transplant might be a treatment option, we'll discuss the details. We'll let you know how you and your child can prepare for the transplant.
By the end of your visit, you will have a care plan tailored to your child’s needs. We'll also schedule a follow-up visit.
You'll meet our social worker nurse practitioner (NP). You can contact our NP by phone or video conference with any concerns between now and your next appointment.
Before you leave, please feel free to ask us about your child's CGD diagnosis, treatment, or anything else.
If my child had tests at the CRDT, when should I expect the results?
We'll call you within 2 weeks to discuss the test results and next steps for your child's CGD care.
You can also find your child's test results if you signed up for MyCHP — Children's patient portal.
MyCHP lets you manage your child's health online. It's free for patients, parents, and guardians of UPMC Children's Hospital of Pittsburgh.
Partners in Your Child's CGD Care
When a child has a rare disease like CGD, it affects the whole family.
At the CRDT, we see each family member as our partners.
The best care approach happens when we merge our CGD expertise with your knowledge of what’s best for your child.
Meet Our Rare Disease Center Patients