Clinical manifestations and expression of CD18 to guide the diagnosis of leukocyte adhesion deficiency type 1: Mexico experience

Allergol Immunopathol (Madr). 2023 Nov 1;51(6):89-96. doi: 10.15586/aei.v51i6.914. eCollection 2023.

Abstract

Background: Leukocyte adhesion deficiency type 1 (LAD-1) is an inborn error of immunity characterized by a defect in leukocyte trafficking.

Methods: Patients with clinical suspicion of LAD-1 were referred to our institution. Complete blood count and flow cytometric analysis, to identify the expression of CD18, CD11b, and the lymphocyte population phenotyping, were performed, and statistical analysis was completed.

Results: We report clinical manifestations and immunological findings of six Mexican patients diagnosed with LAD-1. The diagnosis was based on typical clinical presentation, combined with laboratory demonstration of leukocytosis, and significant reduction or near absence of CD18 and its associated molecules CD11a, CD11b, and CD11c on leukocytes. We found atypical manifestations, not described in other countries, such as early-onset autoimmunity or infections caused by certain microorganisms.

Conclusions: Patients with LAD-1 may present with atypical manifestations, making flow cytometry an indispensable tool to confirm the diagnosis. We present the first report of LAD-1 patients in a Latin American country.

Keywords: CD18; inborn error of immunity; infections; leukocyte adhesion deficiency type-1; leukocytosis.

MeSH terms

  • CD18 Antigens* / metabolism
  • Humans
  • Leukocyte-Adhesion Deficiency Syndrome* / diagnosis
  • Leukocytes
  • Mexico

Substances

  • CD18 Antigens

Supplementary concepts

  • Leukocyte adhesion deficiency type 1