Related Experiment Videos
Persistent low C3 levels associated with meningococcal meningitis and membranoproliferative glomerulonephritis
J Fernandez-Sola1, R Monforte, E Ponz
1Department of Internal Medicine, Hospital Clínic, University of Barcelona, Spain.
Abstract:
Recurrent meningococcal meningitis is usually related to terminal complement factor deficiencies (C5-C8); however it is not frequent with isolated primary C3 deficiency. Similarly, membranoproliferative glomerulonephritis has been described in association with primary C3 deficiencies and the presence of C3 nephritic factor. We present a case of an 18-year-old woman with relapsing meningococcal meningitis in whom membranoproliferative glomerulonephritis and persistent low serum C3 levels were found. A detailed immunological study was performed, but no other abnormalities in the complement components were found. C3 Nef was also negative. Moreover, the familiar complement studies showed an asymptomatic C4 deficiency in her mother and borderline C3 levels in her sister. The presence of persistent low serum C3 levels in the absence of other immunological abnormalities suggests that this is the cause of the relapsing meningococcal infections and the glomerular disease of this patient. We suggest that a complement deficiency, including isolated C3 deficiency, should be ruled out in all cases of relapsing meningitis. Further, the possibility of glomerular disease should be carefully considered in these patients.
Insights
Isolated C3 deficiency can cause recurrent meningococcal meningitis and glomerulonephritis. Early diagnosis and complement testing are crucial for patients with relapsing meningitis.
Area of Science:
- Immunology
- Nephrology
- Infectious Diseases
Background:
- Recurrent meningococcal meningitis is typically linked to terminal complement deficiencies (C5-C8).
- Isolated primary C3 deficiency is an uncommon cause of recurrent meningococcal meningitis.
- Membranoproliferative glomerulonephritis (MPGN) has been associated with C3 deficiencies and C3 nephritic factor.
Observation:
- An 18-year-old female presented with relapsing meningococcal meningitis.
- She also exhibited MPGN and persistently low serum C3 levels.
- Extensive immunological studies revealed no other complement abnormalities, and C3 nephritic factor was negative.
Findings:
- Family studies indicated asymptomatic C4 deficiency in the mother and borderline C3 levels in the sister.
- Persistent low serum C3 levels, in the absence of other immunological issues, were identified as the likely cause of the patient's conditions.
- The patient's presentation suggests a link between isolated C3 deficiency and both recurrent meningococcal infections and glomerular disease.
Implications:
- Complement deficiencies, including isolated C3 deficiency, should be investigated in all patients with recurrent meningitis.
- Glomerular disease should be considered in the differential diagnosis for patients presenting with recurrent meningitis.
- This case highlights the importance of comprehensive complement evaluation in unexplained recurrent infections and renal disease.