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Old 10-06-2011
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Kids Baby with repeated bacterial infections.

A baby presented with recurrent bacterial infections, at different sites, including pneumonia, skin infections with chronic ulcers. The mother mentioned that, he developed reddening & swelling around the stalk of the umbilical cord. In his clinical records always there is leukocytosis, although he has history of repeated skin infections, he never developed abscesses. What is the most accurate diagnostic test?
  • Flow cytometry using 123 fluorescence.
  • Flow cytometry of surface CD11b.
  • Nitroblue tetrazolium reduction test.
  • Reduced absolute T cells count.
  • Bone marrow examination.
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Old 10-06-2011
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is it B?

answer is.....?
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Old 10-06-2011
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This is leukocyte adhesion deficiency.
Flow cytometery for CD11/CD18 should be the answer.
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Old 10-06-2011
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Default B. Flow cytometry of surface CD11b

This is Leukocyte Adhesion Deficiency I

LAD I is characterized clinically by recurrent bacterial infections, a persistent neutrophilia that increases markedly during infection, absent pus formation (a hallmark finding), and impaired wound healing. A classic presenting infection is omphalitis, with delayed separation of the umbilical cord.

LAD I should be considered in any infant with recurrent soft tissue infection and a very high leukocyte count. The diagnosis is made by demonstrating the absence of both CD18 and the associated alpha subunit molecules (CD11a, CD11b, and CD11c) by flow cytometry using CD11 and CD18 monoclonal antibodies.
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Old 10-07-2011
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The correct answer as you said is: Flow cytometry of surface CD11b.
Leukocyte adhesion molecule defec.A congenital leukocyte adhesion molecule defect prevents separation of the umbilical cord. Adhesion molecules activated on neutrophils include selectins and β-integrins (CD11 CD18 positive). Selectins are responsible for rolling of the neutrophils in the venules, while β-integrins cause neutrophils to adhere to venules (margination). Neutrophils then release collagenase, dissolve basement membranes between contracted endothelial cells in venules, and transmigrate into the interstitial tissue. Deficiency of either type of adhesion molecule causes an absence of neutrophil adhesion (margination) and an absence of neutrophils in the interstitial tissue, because neutrophils must adhere to endothelium before they can transmigrate. Other findings in leukocyte adhesion defects include an increase in the absolute neutrophil count, problems with wound healing, and severe gingivitis. No increase in viral infections.Histamine redistributes P-Selectin to endothelial surface. First indication of this disease is often omphalitis. There is high number of granulocytes in the circulation.
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