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International clinical consensus on leukocyte adhesion deficiency-I: Modified Delphi analysis.
Jennifer Heimall1,2, Luis Ignacio González-Granado3,4, Claire Booth5
1Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, Pa.
The Journal of Allergy and Clinical Immunology. Global
|April 21, 2026
Summary
Leukocyte adhesion deficiency-I (LAD-I) requires updated diagnostic and classification guidelines. Expert consensus now integrates laboratory and clinical data for improved management of this rare immune disorder.
Area of Science:
- Immunology
- Genetics
- Pediatrics
Background:
- Leukocyte adhesion deficiency-I (LAD-I) is a severe genetic disorder affecting immune cell function.
- Caused by ITGB2 gene mutations, LAD-I leads to recurrent infections and inflammation.
- Current diagnostic and classification methods need updating due to new insights.
Purpose of the Study:
- To establish international expert consensus on LAD-I diagnosis and severity classification.
- To define the standard of care and burden of illness for severe LAD-I cases.
Main Methods:
- A modified Delphi study involving 12 international experts.
- Two rounds of online questionnaires and a virtual workshop were conducted.
- All experts unanimously approved the final recommendations.
Main Results:
- Consensus reached on 26 recommendations for LAD-I diagnosis and treatment.
- Severity classification should combine laboratory findings with clinical presentation.
- Diagnosis and classification in infants rely on flow cytometry and genetic testing.
Conclusions:
- A new framework aids clinicians in diagnosing, classifying, and treating LAD-I.
- These recommendations promote best practices for better patient outcomes.
