Chronic mucocutaneous candidiasis with
hypoparathyroidism in a 6-year-old-boy is described. In addition to defects of in vivo and in vitro correlates of delayed-type
hypersensitivity to Candida albicans the child also had abnormalities of neutrophil function in terms of their capacity to respond by chemotaxis to a known attractant and to kill
suspensions of C. albicans. Dialysable
transfer factor was given on six occasions at intervals of between 26 and 45 days. Neutrophil chemotaxis (optimal conditions) was restored following each of the six
injections, neutrophil chemotaxis (sub-optimal conditions) following five of the six
injections and candidicidal capacity following four of the six
injections. The effects of
transfer factor were transient requiring repeated
injections. The Candida delayed-type
hypersensitivity skin test was restored to normal but lymphocyte transformation to Candida extract was not consistently positive following treatment. There was a slight clinical improvement following
therapy. These abnormalities of neutrophil and lymphocyte function point to the complexity of
chronic mucocutaneous candidiasis. The improvement in neutrophil chemotaxis and candidicidal capacity following treatment suggests that
transfer factor may be a heterogeneous group of molecules, some of which affect granulocytes and restore defects in their function.