RT Book, Section A1 Borregaard, Niels A2 Kaushansky, Kenneth A2 Lichtman, Marshall A. A2 Prchal, Josef T. A2 Levi, Marcel M. A2 Press, Oliver W. A2 Burns, Linda J. A2 Caligiuri, Michael SR Print(0) ID 1121096169 T1 Disorders of Neutrophil Function T2 Williams Hematology, 9e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071833004 LK hemonc.mhmedical.com/content.aspx?aid=1121096169 RD 2024/04/19 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 one of the following clinical features: (1) two or more systemic bacterial infections in a relatively short time period; (2) frequent, serious respiratory infections, such as pneumonia or sinusitis, or otitis media, or lymphadenitis; (3) infections present at unusual sites (liver or brain abscess); and (4) infections associated with unusual pathogens (e.g., Aspergillus pneumonia, disseminated candidiasis, or infections with Serratiamarcescens, Nocardia species, or Burkholderia cepacia).