Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Leukocyte Adhesion Deficiency

By

James Fernandez

, MD, PhD, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University

Reviewed/Revised Jan 2023
VIEW PROFESSIONAL VERSION

Leukocyte adhesion deficiency is an immunodeficiency disorder in which white blood cells (leukocytes) do not function normally, causing frequent soft-tissue infections.

  • Symptoms of leukocyte adhesion deficiency usually begin during infancy and include frequent infections in soft tissues, such as the gums, skin, and muscles.

  • Doctors do special blood tests to diagnose the disorder.

  • Treatment involves antibiotics to prevent infections and transfusions of white blood cells, but stem cell transplantation is the only effective treatment.

In leukocyte adhesion deficiency, white blood cells Components of the Immune System The immune system is designed to defend the body against foreign or dangerous invaders. Such invaders include Microorganisms (commonly called germs, such as bacteria, viruses, and fungi) Parasites... read more are lacking one of several proteins on their surface that help the cells move and to attach (adhere) to blood vessels and foreign cells. As a result, white blood cells are less able to travel to sites of infection and to kill and ingest bacteria and other foreign invaders.

There are three forms of this disorder that are distinguished by the specific biochemical part of the immune system affected.

Symptoms of Leukocyte Adhesion Deficiency

Symptoms of leukocyte adhesion deficiency usually begin during infancy.

In severely affected infants, infections develop in soft tissues, such as the gums, skin, and muscles. These infections recur and/or become worse, and affected tissues may die. No pus forms in infected areas. Infections become increasingly difficult to control.

Wounds do not heal well.

Often, the umbilical cord is slow to fall off, taking 3 weeks or more after birth. Normally, the umbilical cord falls off on its own a week or two after birth.

Most children with severe disease die by age 5 years unless treated successfully with stem cell transplantation.

Less severely affected infants have few serious infections. They can survive until adulthood without treatment.

In children with one form of leukocyte adhesion deficiency, intellectual and physical development is often slow.

Diagnosis of Leukocyte Adhesion Deficiency

  • Blood tests

A complete blood count is done. Also, special blood tests, including analysis of proteins on the surface of white blood cells (called flow cytometry), are used to diagnose leukocyte adhesion deficiency.

Genetic testing is recommended for siblings.

Treatment of Leukocyte Adhesion Deficiency

  • Antibiotics

  • Granulocyte transfusions

  • Stem cell transplantation

Treatment of leukocyte adhesion deficiency includes antibiotics, often given continuously, to prevent infections. Transfusions of granulocytes (a type of white blood cells) can also help.

Gene therapy for this disorder is being studied.

For children with one type of the disorder, taking fucose (a sugar) supplements may help

More Information

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
VIEW PROFESSIONAL VERSION
quiz link

Test your knowledge

Take a Quiz!
iOS ANDROID
iOS ANDROID
iOS ANDROID
TOP