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Lazy Leukocyte Syndrome

The lazy leukocyte syndrome was first described by Miller et al. in 1971 in two children with recurrent infection. They had normal humoral and cellular immunity with a neutropenia, but adequate numbers of neutrophils in the bone marrow. Intracellular killing and phagocytosis were intact, the defect being in the mobilization of functionally normal neutrophils in response to chemical and inflammatory stimuli. Further cases have been described by Constantopoulos et al. (1975) and Yoda et al. (1980). The patient now reported has many features of the syndrome but differs in that skin window mobilization test and chemotaxis were normal. T-cell subsets have been examined for the first time in this context, and in addition a characteristic abnormality of actin distribution within the neutrophils has been demonstrated.