[PAGID] CGD and bladder wall thickening

[John Ziegler]

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Findings like this may be associated with an IBD picture. Are there features
of IBD?

-----Original Message-----
From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Chris Seroogy
Sent: Tuesday, 4 March 2008 9:42 AM
To: pagid at list.clinimmsoc.org
Subject: [PAGID] CGD and bladder wall thickening


We have a 4y/o boy with X-linked CGD and a right wall bladder thickening,
dysuria and hematuria.  Culture negative, ESR normal and afebrile.

The imaging consisted of U/S and CT with contrast.  It does not have the
characteristics of a rhabdo and given his age in situ carcinoma is rare.  I
am inclined to assume this is non-infectious granulomatous disease and treat
with oral steroids.  His history is notable for gastric antrum granulomas
this past Fall responsive to oral steroids and aspergillus pneumonia at
presentation 3 years ago.

My questions:


1. Would people be comfortable with empiric steroid treatment or is the
risk/invasive nature of cytoscopy with bx/culture warranted?

2. Should empiric antibiotics be started?  If so, what regimen?

Thank you for your thoughts! Chris



Chris Seroogy, M.D.

Assistant Professor

Dept. of Pediatrics

Mail:  H4/474 CSC, Mailstop 4108

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600 Highland Ave.

Madison, WI  53792

phone: 608- 263-2652

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