Disorders of neutrophil function. Defects in the early stages of the phagocytic process.

Neutrophils from three patients with recurrent infections were studied for defects in the phagocytic process. In one, random and directed migration, adherence and ability to kill Gram-negative bacteria were defective. In a second patient random and directed migration was abnormal, but adherence was unimpaired; this patient also had an impaired ability to kill Gram-negative bacteria. The third patient had defective leucocyte motility, inability to reduce nitro-blue tetra-zolium dye, and deficient killing of both and Gram-negative organisms. This patient's mother showed an intermediate bacterial killing defect consistent with the heterozygous state. The previously unrecognized patterns of defects in these patients emphasize the importance of early cell-membrane associated events to the ultimate success of the bactericidal process, and illustrate the heterogeneity of defects responsible for impaired neutrophil function.