Highlighting the problematic reliance on CD18 for diagnosing leukocyte adhesion deficiency type 1

Sarina Levy-Mendelovich, Erez Rechavi, Omar Abuzaitoun, Helly Vernitsky, Amos J. Simon, Atar Lev, Raz Somech

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Leukocyte adhesion deficiency type 1 (LAD-1) is an autosomal recessive primary immunodeficiency, hallmarked by defective polymorphonuclear transmigration. It is caused by mutations in the gene encoding CD18, which interfere with the CD18/CD11 heterodimerization and expression on leukocyte cell surface. LAD-1 diagnosis rests primarily on the measurement of CD18 expression. However, CD18 measurement entails its pitfalls. Here we present a cohort of ten LAD patients and a review of the relevant literature illustrating the difficulties in sole reliance on CD18 measurement for initial diagnosis. These include normal range expression in some mutations, great variability between patients with the same mutation and subjective interpretation of results. We think there is a need for additional markers as part of the initial LAD diagnostic algorithm. We suggest CD11a expression, which was near absent in all patients in our cohort. The dual use of CD18 and CD11a can increase testing sensitivity and prevent delayed diagnosis of LAD-1.

Original languageEnglish
Pages (from-to)476-482
Number of pages7
JournalImmunologic Research
Issue number2
StatePublished - 1 Apr 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015, Springer Science+Business Media New York.


  • CD11a
  • CD18
  • FACS
  • Leukocyte adhesion deficiency


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