Lymphocyte-monocyte defect associated with anergy and recurrent infections.

Mechanisms of cellular immunity were studied in an anergic female with recurrent bacterial infections. Lymphocytes transformed and produced cytotoxin in the presence of phytohaemagglutinin, but elaborated only migration inhibitory factor (MIF) in response to specific antigen. Monocytes isolated from the patient's peripheral blood were unresponsive to autologous MIF and to homologous MIF from two of three healthy adults. Humoral immunity, complement and neutrophil bactericidal activity were intact. The lymphocyte-monocyte defects found in this patient suggest that they were responsible for the anergy and predisposition to bacterial infections.