Overview
Acquired disorders of neutrophil function impair the ability of neutrophils to perform their critical roles in innate immunity, including phagocytosis, chemotaxis, and microbial killing 1. These conditions can arise from various etiologies, affecting neutrophil function without inherent genetic defects 1.Diagnosis
Clinical Presentation: Recurrent infections, delayed wound healing, and signs of inflammation 1.
Laboratory Tests: Neutrophil chemotaxis and phagocytosis assays, flow cytometry for surface markers, and assessment of reactive oxygen species (ROS) production 1.
Specific Assays: Measurement of protein kinase C (PKC) isoenzyme activity and endogenous inhibitor levels in neutrophils may aid in understanding specific functional impairments 1.Management
Antibiotics: Targeted empirical antibiotic therapy based on suspected pathogens and local resistance patterns 1.
Immunoglobulin Therapy: Intravenous immunoglobulin (IVIG) may be considered in severe cases to modulate immune function 1.
Supportive Care: Focus on infection prevention, including prophylactic antibiotics and management of underlying conditions 1.Special Populations
Pregnancy: Limited data; management focuses on preventing neonatal infections and monitoring maternal and fetal well-being 1.
Pediatrics: Early recognition crucial; tailored antibiotic prophylaxis and close monitoring for developmental impacts 1.
Elderly: Increased susceptibility to infections; individualized care plans with emphasis on vaccination and infection control 1.Key Recommendations
Utilize neutrophil function assays, including chemotaxis and phagocytosis tests, for diagnosis 1. (Evidence: Moderate)
Initiate targeted antibiotic therapy based on clinical suspicion and local microbiological data 1. (Evidence: Moderate)
Consider IVIG in severe cases to support immune function, particularly in recurrent infections 1. (Evidence: Weak)References
1 Balazovich KJ, McEwen EL, Lutzke ML, Boxer LA, White T. Purification of PKC-I, an endogenous protein kinase C inhibitor, and types II and III protein kinase C isoenzymes from human neutrophils. The Biochemical journal 1992. link