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Meningococcal endocarditis with profound acquired hypocomplementaemia.

A P Weetman, N Matthews, S P O'Hara

    The Journal of Infection
    |January 1, 1985
    PubMed
    Summary
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    This case study highlights Neisseria meningitidis endocarditis causing kidney disease. Low complement levels persisted until immune complexes cleared post-surgery, suggesting a role in chronic illness.

    Area of Science:

    • Cardiology
    • Nephrology
    • Infectious Diseases

    Background:

    • Chronic endocarditis can affect heart valves and lead to systemic complications.
    • Neisseria meningitidis is a rare but serious cause of endocarditis.
    • Glomerulonephritis and nephrotic syndrome can be associated with infective endocarditis.

    Observation:

    • A patient presented with chronic endocarditis caused by Neisseria meningitidis on a normal mitral valve.
    • The patient developed glomerulonephritis, renal impairment, and nephrotic syndrome.
    • Serum complement levels remained low despite antibiotics and valve replacement.

    Findings:

    • Low complement levels normalized only after the clearance of immune complexes and type III cryoglobulin.
    • Clearance occurred three months post-resection of valve vegetation.

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  • Acquired hypocomplementaemia may have contributed to the chronicity of the endocarditis.

    • Implications:

    • This case underscores the complex interplay between infection, immune response, and organ damage in endocarditis.
    • Understanding complement pathways is crucial for managing chronic infectious and autoimmune conditions.
    • Early identification and management of immune complex deposition may improve outcomes in severe endocarditis.