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Cognitive Function in Patients With Chronic Granulomatous Disease: A Preliminary Report

Received Aug. 8, 2002; revision received July 30, 2003; accepted Aug. 28, 2003. From the Department of Psychiatry, Children's National Medical Center, Washington, D.C.; and the Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases. Address reprint requests to Dr. Holland, the Laboratory of Host Defenses, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Building 10, Room 11N103, 10 Center Dr., MSC 1886, Bethesda, MD 20892-1886; smh{at}nih.gov (e-mail).

Chronic granulomatous disease is an inherited immunodeficiency in which phagocytes fail to generate superoxide and its metabolites, resulting in severe recurrent infections and frequent hospitalizations. Chronic illness and frequent hospitalizations can affect growth and development as well as social and educational opportunities. Since no data have been reported on cognitive functioning in patients with this illness, the authors sought to examine cognitive function in a group of patients with chronic granulomatous disease. A retrospective chart review of 26 patients seen and followed at the National Institutes of Health who had received cognitive testing at the request of parent or staff was performed. Demographic information including medical, psychiatric, and developmental histories was gathered. Six patients (23%) were found to have an IQ of 70 or below, indicative of cognitive deficits, and all of those patients had defects in the membrane-linked cytochrome b558. The prevalence of cognitive deficits in this selected population of chronic granulomatous disease patients was high. The determination of the true distribution of cognitive functioning in the general chronic granulomatous disease population is important, since cognitive deficits have implications for educational planning and potential therapies such as transplantation and gene therapy in children.

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