RT Book, Section
A1 Borregaard, Niels
A1 Kuijpers, Taco
A2 Kaushansky, Kenneth
A2 Prchal, Josef T.
A2 Burns, Linda J.
A2 Lichtman, Marshall A.
A2 Levi, Marcel
A2 Linch, David C.
SR Print(0)
ID 1178748102
T1 Disorders of Neutrophil Function
T2 Williams Hematology, 10e
YR 2021
FD 2021
PB McGraw-Hill Education
PP New York, NY
SN 9781260464122
LK accessmedicine.mhmedical.com/content.aspx?aid=1178748102
RD 2024/04/18
AB SUMMARYThe  neutrophil  circulates  in  blood  as  a  quiescent  cell*.  Its  main  function  as  a  phagocytic  and  bactericidal  cell  is  performed  outside  the  circulation  in  tissues  where  microbial  invasion  takes  place.  Neutrophil  function  is  traditionally  viewed  as  chemotaxis,  phagocytosis,  and  bacterial  killing.  Although  these  conceptionally  represent  distinct  entities,  they  are  functionally  related,  and  rely  to  a  large  extent  on  the  same  intracellular  signal  transduction  mechanisms  that  result  in  localized  rises  in  intracellular  Ca2+,  changes  in  organization  of  the  cytoskeleton,  assembly  of  the  nicotinamide  adenine  dinucleotide  phosphate  (NADPH)  oxidase  from  its  cytosolic  and  membrane  integrated  subunits,  and  fusion  of  granules  with  the  phagosome  or  neutrophil  plasma  membrane.  Clinical  disorders  of  the  neutrophil  may  arise  from  impairment  of  these  normal  functions.  The  clinical  presentation  of  a  patient  who  has  a  qualitative  neutrophil  abnormality  may  be  similar  to  that  of  one  who  has  an  antibody,  complement,  or  toll-like  receptor  disorder.  In  general,  evaluation  for  phagocyte  cell  disorders  should  be  initiated  among  those  patients  who  have  at  least  1  of  the  following  clinical  features:  (a)  2  or  more  systemic  bacterial  infections  in  a  relatively  short  period;  (b)  frequent,  serious  respiratory  tract  infections,  such  as  pneumonia  or  sinusitis,  or  otitis  media,  or  lymphadenitis;  (c)  infections  present  at  unusual  sites  (liver  or  brain  abscess);  and  (d)  infections  associated  with  unusual  pathogens  (eg,  Aspergillus  pneumonia,  disseminated  candidiasis,  or  infections  with  Serratia  marcescens,  Nocardia  species,  or  Burkholderia  cepacia).