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Pathology · Inflammation: myeloperoxidase deficiency
Sample itemA 55-year-old man with poorly controlled diabetes has had recurrent Candida infections. A nitroblue tetrazolium test is normal, but his neutrophils fail to generate hypochlorous acid from hydrogen peroxide. Which disorder is this?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Myeloperoxidase deficiency
Myeloperoxidase converts hydrogen peroxide and chloride into hypochlorous acid, a major microbicidal product. Its deficiency is the commonest inherited phagocyte disorder and is usually asymptomatic, though Candida infection may occur, particularly in diabetics. The oxidative burst itself, and so the nitroblue tetrazolium test, is normal.
Option by option
A. Leukocyte adhesion deficiency type 1
Leukocyte adhesion deficiency type 1 impairs adhesion and gives neutrophilia without pus.
B. Myeloperoxidase deficiency (correct)
Correct. A normal respiratory burst with failure of hypochlorous acid formation is typical of this enzyme defect.
C. Chronic granulomatous disease
Chronic granulomatous disease has a failed burst and an abnormal nitroblue tetrazolium test.
D. Chediak-Higashi syndrome
Chediak-Higashi syndrome shows giant granules and albinism, not isolated failure of hypochlorous acid formation.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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