Abstract
Chronic granulomatous disease(CGD) is a heterogeneous, inherited primary immunodeficiency disease. It is usually diagnosed under five years age. It is characterized by granuloma formation due to increased inflammatory response. We report 2 cases with CGD to emphasize that all granuloma forming diseases are not tuberculosis (TB), CGD must be considered in differential diagnosis in adults in populations with high incidence of consanguineous marriagesCase 1: 26 years old female patient has been on TB treatment for 5 months was admitted with respiratory failure. Although her initial sputum and culture negative for AFB, granulomatous inflammation was observed by surgical lung biopsy. Because of no response to treatment, patient was referred to our clinic with suspicion of MDR-TB. Galactomannan, cultures and 3 ARB results were negative. In medical history, recurrent infections and abscesses were in childhood. She had 4 times anti-TB therapy (smears and cultures were negative for AFB). In family history, her father and mother had consanguineous marriage, her siblings in their childhood had abscesses and anti-TB therapy, twin sisters died in nine months. The patient was consulted to immunology. Nitroblue tetrazolium test has resulted negative. She was diagnosed as CGD.Case-2: 19 year-old male patient was admitted with the complaints of fever, a swelling of anterior chrest wall and pneumonic infiltration on thorax CT. Physical examination revealed 3x5 cm fluactant swelling,redness and warmth on anterior chest wall. In medical history, he had 3 times pneumonia in last two years. AFB and culture were negative. Dihydrorhodamine 123 flow cytometry test resulted compatible with autosomal recessive form of CGD.