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Immunological features in a case of chronic granulomatous candidiasis and its treatment with transfer factor.

A boy aged 6 years with severe chronic mucocutaneous candidiasis of the granulomatous variety has been treated with the dialysable transfer factor. Before the treatment he was unable to express delayed hypersensitivity. His lymphocytes were able, however, to produce migration inhibitory factor following in vitro challenge with soluble candida antigens, but this activation was not accompanied by a significant increase in DNA synthesis. 
 
The treatment resulted in a temporary clinical improvement and return to normal of his immune responses. After a relapse he was, 6 months later, once more injected with transfer factor, which again proved effective. 
 
Evidence is presented which suggests a defect of monocyte-macrophage function in this patient and the pathogenesis of candida granulomata is discussed. It is postulated that an amplifying mechanism involving lymphocyte-macrophage interaction is required for the normal expression of delayed hypersensitivity reactions and the effective elimination of Candida albicans.