Delayed separation of the umbilical cord and partial deficiency of sialyl Lewis X antigen

A 5-week-old male infant presented with failure of separation of the umbili cal cord, He was evaluated for the presence of integrin and selectin ligand leukocyte adhesion molecules on his neutrophils and monocytes. Integrin mo lecules appeared to be normally expressed, but expression of sialyl Lewis X (sLe(X)) was decreased. The expression of sLe(X) gradually increased, and the umbilical cord separated at 10 weeks of age. Further study revealed dec reased numbers of sLe(X)-positive neutrophils with a lower mean fluorescenc e intensity on neutrophils from cord blood compared to neutrophils in adult peripheral blood. This study indicates that this patient had an uncommonly low level of sLe(X) expression and infers that adequate expression may be required for the inflammatory reaction needed for umbilical cord separation . Copyright (C) 1999 S. Karger AG, Basel.