Malakoplakia: Evidence for Monocyte Lysosomal Abnormality Correctable by Cholinergic Agonist in Vitro and in Vivo

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Abstract
We studied monocyte function in a case of malakoplakia in an attempt to characterize the immune defect in this condition. Our patient's intracellular cyclic-GMP levels were abnormally low (mean ± S.D. of 0.17±0.05 pmol per 107 malakoplakia cells, versus 0.79±0.12 in normals) (PEscherichia coli allowed growth of 542±46 colonies, normal monocytes allowed 95±22 (P<0.001). The percentage of monocytes with large lysosomal granules was 23±4 in the patient and 4±2 in normal controls. After in vitro incubation of the patient's cells or in vivo treatment with bethanechol chloride, the cyclic-GMP levels, bactericidal ability and lysosomal granules of the cells returned to normal levels.

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