Král V, Bartůnková J, Svorc K, Calda P, Jílek D, Kobylka P, Starý J
Imunologický odbor KHES, Ustí nad Labem, LF UK a VFN, Praha.
Cas Lek Cesk. 1996 Mar 6;135(5):154-8.
The syndrome of leukocyte adhesion deficiency (LAD) is a rare congenital immunodeficiency which is usually manifested from birth by serious infections of the skin and mucosal membranes. The molecular basis of the disease is heterogeneous: quantitative or qualitative disorders of the beta 2 integrin sub-unit are involved which lead to the absence or substantially reduced expression of adhesive molecules of the CD11/CD18 complex on leukocytes. The authors describe the case of a boy who suffered from this syndrome. The diagnosis was established at the age of four years, based on the typical clinical picture and confirmed by examination of integrins on lymphocytes and granulocytes which were zero. During the mother's subsequent pregnancy prenatal diagnosis was made by puncture of the umbilical cord during the 22nd week of gestation. Affection of the foetus by this syndrome was ruled out by examination of integrin expression on foetal leukocytes, a normal finding was confirmed also after delivery. During delivery umbilical blood was collected which was frozen and later used for therapeutic transplantation to the sibling suffering from LAD. This is the first case of this syndrome in the Czech Republic and first prenatal diagnosis which led to aimed collection of umbilical blood used for treatment of this rare immunodeficiency.
白细胞黏附缺陷综合征(LAD)是一种罕见的先天性免疫缺陷病,通常自出生起就表现为皮肤和黏膜的严重感染。该疾病的分子基础具有异质性:涉及β2整合素亚单位的数量或质量紊乱,导致白细胞上CD11/CD18复合物黏附分子的缺失或表达大幅降低。作者描述了一名患有该综合征的男孩的病例。诊断在其四岁时依据典型临床表现确立,并通过淋巴细胞和粒细胞上整合素检测结果为零得到证实。在母亲随后的孕期中,于妊娠第22周通过脐带穿刺进行了产前诊断。通过检测胎儿白细胞上的整合素表达排除了胎儿患该综合征的可能,产后检查也证实结果正常。分娩时采集了脐带血,冷冻后用于对患LAD的同胞进行治疗性移植。这是捷克共和国首例该综合征病例以及首例产前诊断,该诊断使得脐带血得以有针对性地采集用于治疗这种罕见的免疫缺陷病。