Functional neutrophil disorders

An increased susceptibility to infection is well recognized in conditions associated with defects in phagocytic function. These defects occur in many systemic conditions, including diabetes mellitus, uremia, malnourishment, and alcohol ingestion, and following corticosteroid therapy. There are also well-recognized but exceedingly rare inherited defects of phagocyte function, the most striking being chronic granulomatous disease in which neutrophils are unable to kill catalase-positive micro-organisms such as staphylococci, Serratia, Candida, and Aspergillus. These organisms survive intracellularly, resulting in chronic local granulomatous inflammation. The defect in chronic granulomatous disease involves an enzyme in the respiratory burst of oxidative metabolism that accompanies phagocytosis. Unless the disease has previously been recognized in the family, the diagnosis is usually made when the clinical picture of recurrent infection prompts investigation of neutrophil and immune function.

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