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Case Reports
. 2015 Mar;61(3):260-8.
doi: 10.1007/s12026-014-8619-8.

Successful adjunctive immunoglobulin treatment in patients affected by leukocyte adhesion deficiency type 1 (LAD-1)

Marco Yamazaki-Nakashimada  1 , José L Maravillas-Montero, Laura Berrón-Ruiz, Orestes López-Ortega, Noé Ramírez-Alejo, Ernesto Acevedo-Ochoa, Francisco Rivas-Larrauri, Beatriz Llamas-Guillén, Lizbeth Blancas-Galicia, Selma Scheffler-Mendoza, Alberto Olaya-Vargas, Leopoldo Santos-Argumedo
Affiliations
Case Reports

Successful adjunctive immunoglobulin treatment in patients affected by leukocyte adhesion deficiency type 1 (LAD-1)

Marco Yamazaki-Nakashimada et al. Immunol Res. 2015 Mar.

Abstract

Two patients with a severe leukocyte adhesion deficiency type 1 (LAD-1) phenotype were analyzed by flow cytometry and functional assays to demonstrate the improper adhesive and phagocytic responses of their leukocytes. A single homozygous defect that involves a missense mutation (c.817G>A) that encodes for a G273R substitution in CD18 was identified in both patients. The adhesion and phagocytosis assays demonstrated the inability of patients' leukocytes to perform these functions. Expression of the LFA-1 (CD11a/CD18) on the co-transfected HEK 293 cells with the mutated form of CD18 was not detected. Finally, both patients have been treated with immunoglobulin as an adjunctive therapy with positive results. We propose that intravenous immunoglobulin treatment is safe and efficacious in LAD-1 patients before hematopoietic stem cell transplantation and helpful in controlling severe infections. Subcutaneous immunoglobulin appeared to help wound healing in refractory ulcers in these patients.

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