A CASE OF ACUTE CORONARY SYNDROME UNDER IMMUNSUPRESSION WHO IS THE CRIMINAL NEUTROPHILS OR T CELLS?

Abstract

Chronic granulomatous disease (CGD) is a primary immunodeficiency characterized by recurrent, life-threatening bacterial and fungal infections of the skin, airways, lymph nodes, liver, brain, and bones. These infections most commonly occur in organs in contact with the outside world (lungs, gastrointestinal tract, and skin), as well as in lymph nodes that drain these structures. While involvement can be seen in many organs, there is no known cardiovascular involvement. Our case is an ACS case that has a different place in the literature because acute coronary syndrome (ACS) was seen in a 20-year-old male patient with a diagnosis of chronic granulomatous disease.

Keywords

• Acute coronary syndrome
• Bone marrow replacement therapy
• Chronic granulomatous disease
• Coronary angiography
• GraftVersus Host Disease

References

1. 1- Azimi, Parvin H., et al. "Chronic granulomatous disease in three female siblings." Jama 206.13 (1968): 2865-2870.
2. 2- Winkelstein, Jerry A., et al. " Chronic granulomatous disease. Report on a national registry of 368 patients. " Medicine (Baltimore). 2000 May;79(3):155-69.
3. 3- Köker MY, Camcıoğlu Y, et al. “Clinical, functional, and genetic characterization of chronic granulomatous disease in 89 Turkish patients.” J Allergy Clin Immunol. 2013 Nov;132(5):1156-1163.e5.
4. 4- Fattahi F, Badalzadeh M, et al. “Inheritance pattern and clinical aspects of 93 Iranian patients with chronic granulomatous disease.” J Clin Immunol. 2011 Oct;31(5):792-801.
5. 5- Wolach B, Gavrieli R, et al. “Chronic granulomatous disease: Clinical, functional, molecular, and genetic studies. The Israeli experience with 84 patients. “ Am J Hematol. 2017 Jan;92(1):28-36.
6. 6- Marciano BE, Spalding C, et al. “Common severe infections in chronic granulomatous disease.” Clin Infect Dis. 2015 Apr 15;60(8):1176-83.
7. 7- Maydana M, Cabanillas D, et al. “Chronic granulomatous disease: multiple infections as clinical presentation. Pediatric case report.” Arch Argent Pediatr. 2018 Dec 1;116(6):e744-e748. Spanish.
8. 8- Prince, Benjamin T et al. “Geographic Variability and Pathogen-Specific Considerations in the Diagnosis and Management of Chronic Granulomatous Disease.” Pediatric health, medicine and therapeutics vol. 11 257-268. 22 Jul. 2020

9. 9- Chiesa R, Wang J, et al. “Hematopoietic cell transplantation in chronic granulomatous disease: a study of 712 children and adults.” Blood. 2020 Sep 3;136(10):1201-1211.