Clinical and laboratory findings in patients with leukocyte adhesion deficiency type I: A multicenter study in Turkey

Ismail Yaz, Begum Ozbek, Hacer Neslihan Bildik, Cagman Tan, Sevil Oskay Halacli, Elif Soyak Aytekin, Saliha Esenboga, Sukru Cekic, Sara Sebnem Kilic, Ozlem Keskin, Karin van Leeuwen, Dirk Roos, Deniz Cagdas, Ilhan Tezcan

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Leukocyte adhesion deficiency type I is a rare primary immunodeficiency disorder characterized by mutations in the ITGB2 gene encoding CD18. We present clinical and immunological features of 15 patients with leukocyte adhesion deficiency type 1 (LAD-1). Targeted next-generation sequencing was performed with either a primary immunodeficiency gene panel comprising 266 genes or a small LAD-panel consisting of five genes for genetic analysis. To measure the expression level of integrins on the leukocyte surface, flow cytometry analysis was performed. The median age of the patients at diagnosis was 3 (1–48) months. Eleven (73%) of the 15 patients had a LAD-1 diagnosis in their first 6 months and 14 (93%) patients had consanguineous parents. Delayed separation of the umbilical cord was present in 80% (n = 12) of the patients in our cohort, whereas omphalitis was observed in 53% (n = 8) of the patients. Leukocytosis with neutrophil predominance was observed in 73% (n = 11) patients. Nine distinct variants in the ITGB2 gene in 13 of the 15 patients with LAD-1 were characterized, two of which (c.305_306delAA and c.779_786dup) are novel homozygous mutations of ITGB2. Four unrelated patients from Syria had a novel c.305_306delAA mutation that might be a founder effect for patients of Syrian origin. Four (27%) patients underwent hematopoietic stem cell transplantation. Two patients died because of HSCT complications and the other two are alive and well. Early differential diagnosis of the patients is critical in the management of the disease and genetic evaluation provides a basis for family studies and genetic counseling.
Original languageEnglish
Pages (from-to)47-55
Number of pages9
JournalClinical and Experimental Immunology
Issue number1
Early online date2021
Publication statusPublished - Oct 2021


  • CD18
  • HSCT
  • ITGB2
  • integrin
  • leukocyte adhesion deficiency type 1 (LAD-1)

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