NEUTROPHIL AND MONOCYTE FUNCTION IN PEDIATRIC-PATIENTS WITH RECURRENT PNEUMONIAS - A LONGITUDINAL-STUDY

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Abstract
Peripheral neutrophil and monocyte function was studied in 24 pediatric patients with recurrent lower respiratory tract infections. The age range of the patients was 4 mo.-12 yr with a mean of 32 mo. Depressed neutrophil chemiluminescence activity was observed in 46% of the 24 patients, depressed neutrophil chemotactic responsiveness was observed in 27% of 22 patients, depressed monocyte chemiluminescence was observed in 31% of 16 patients and depressed monocyte chemotaxis was observed in 45% of 20 patients. Of the 11 patients with abnormal neutrophil chemiluminescence, 56% also had abnormal neutrophil chemotaxis. Of the 11 patients with depressed neutrophil chemiluminescence, 8 were retested 9 mo.-1 yr after initial testing, and in 5 of the 8, chemiluminesence had returned to normal; in the other 3, it had remained depressed. The 3 whose neutrophil chemiluminescence remained depressed continued to have repeated pneumonias, as did 1 patient whose values had returned to normal. The estimated probability of return to normal for the neutrophil chemiluminescence after 1 yr was 0.625. Because the ability to move functionally intact neutrophils and monocytes into the lung is important for effective lung defense, this defective phagocytic cell function may be directly related to the recurrent pneumonias found in these pediatric patients.