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A 5-year-old boy was diagnosed as having chronic mucocutaneous candidiasis at the age of three months. He showed no improvement despite treatment with two courses of intravenous amphotericin B, 21⁄2 years of oral 5-fluorocytosine, and daily treatment with topical Mycostatin. An immune assessment revealed that he was anergic and had low levels of circulating FCγR+ monocytes. Buccal smears revealed numerous candida and no inflammatory response. On treatment with transfer factor his FCγR+ monocyte count increased from 10 to 429 cells/cumm, his total monocyte count rose from 175 to 1,100 cells/cumm, his candida-induced migration inhibition factor production increased by 36%, and his buccal smears showed infiltration with phagocytic leukocytes. He developed delayed cutaneous hypersensitivity to candida antigen and demonstrated marked improvement in his candidiasis. At age seven he developed adrenal insufficiency and hypoparathyroidism and hence fit the criteria for the diagnosis of autoimmune polyendocrinopathy syndrome type-1 (APS-1).

Transfer Factor Revisited: Treatment of Chronic Mucocutaneous Candidiasis in a Child with Autoimmune Polyendocrinopathy Syndrome Type-1