Definition
- Inherited or acquired disorders affecting neutrophils (and other leukocytes) may result in abnormal function and a predisposition to recurrent bacterial infections. Acquired neutrophil dysfunction may be the result of disorders of immunoglobulins, complement, or T cells; in such cases, the underlying disease should be characterized before specific assays for neutrophil dysfunction are undertaken.
Use
- Neutrophil function tests are used to evaluate neutrophil dysfunction in patients with recurrent bacterial infections, especially in patients with a family history suggestive of a neutrophil dysfunction syndrome. The functions used to investigate neutrophil dysfunction are adherence, locomotion, phagocytosis, and secretion (see Table 16.58). Morphologic studies are performed in parallel with the functional assays.
- Because of the rarity of these conditions, only a limited number are mentioned (see Table 16.58).
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TABLE 16 " “58Assays for Suspected Congenital Neutrophil Dysfunction SyndromesView LargeTABLE 16 " “58Assays for Suspected Congenital Neutrophil Dysfunction Syndromes Assay Abnormal in NBT slide test: abnormal (negative test) Chronic granulomatous disease Decreased chemotaxis (and giant granules) Chediak-Higashi syndrome Mo-1, chemotaxis, and bacterial killing are markedly reduced; can be tested also by flow cytometry Leukocyte adhesion deficiency Myeloperoxidase (for neutrophils) and lysozyme (for monocytes) Primary myeloperoxidase deficiency (MYD) Chemotaxis and antilactoferrin stain of polymorphonuclear neutrophils are markedly reduced Specific granule deficiency Chemotaxis and bacterial killing are markedly decreased Neutrophil actin dysfunction, a genetic disorder