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April 1979

Identification of a Neutrophil Chemotactic Inhibitor in a Patient With Recurrent Pyoderma

Author Affiliations

From the Departments of Pediatrics (Dr Robinson) and Medicine (Dr Kelly), Division of Dermatology (Dr Kelly), Martin Luther King Jr General Hospital, and Charles R. Drew Postgraduate Medical School, Los Angeles.

Arch Dermatol. 1979;115(4):453-457. doi:10.1001/archderm.1979.04010040031010

Host defense mechanisms were studied in a patient with recurrent pyoderma of the scalp. Evaluation of the patient's inflammatory response demonstrated normal yeast phagocytosis, normal capillary tube migration, normal results from a nitroblue tetrazolium dye test, and significantly decreased neutrophil chemotactic response (NC). The impaired NC was associated with a heat labile plasma inhibitor. Chromatography of the patient's and of normal human plasma demonstrated three distinct protein peaks. Chemotactic inhibitory activity was found in the third peak of the patient's plasma but not in the control plasma. Normal in vitro NC was restored when greater than 40% normal human plasma was added to the column fractions that contained the inhibitor. Based on these findings, a subsequent exacerbation of the patient's pyoderma was treated with fresh frozen plasma, and dramatic clinical improvement occurred within 72 hours.

(Arch Dermatol 115:453-457, 1979)

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