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The Clinical Spectrum of Leukocyte Adhesion Deficiency (LAD) III due to Defective CalDAG-GEF1



Leukocyte adhesion deficiency (LAD) type III is a rare syndrome characterized by severe recurrent infections, leukocytosis, and increased bleeding tendency. All integrins are normally expressed yet a defect in their activation leads to the observed clinical manifestations.

Materials and Methods

Less than 20 patients have been reported world wide and the primary genetic defect was identified in some of them. Here we describe the clinical features of patients in whom a mutation in the calcium and diacylglycerol-regulated guanine nucleotide exchange factor 1 (CalDAG GEF1) was found and compare them to other cases of LAD III and to animal models harboring a mutation in the CalDAG GEF1 gene.


The hallmarks of the syndrome are recurrent infections accompanied by severe bleeding episodes distinguished by osteopetrosis like bone abnormalities and neurodevelopmental defects.

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We would like to thank Prof. Alon for critically reviewing the paper and to Prof. Rechavi’s group for helping in the genetic analysis of the families.

Recently we found that these patients have also mutation in Kindlin 3 (Blood Accepted).

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Correspondence to Amos Etzioni.

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Kilic, S.S., Etzioni, A. The Clinical Spectrum of Leukocyte Adhesion Deficiency (LAD) III due to Defective CalDAG-GEF1. J Clin Immunol 29, 117–122 (2009).

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  • Leukocytes
  • platelets
  • integrins
  • adhesion
  • infections
  • bleeding
  • immunodeficiency