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[Complement deficiencies and meningococcal disease in The Netherlands]
A G Swart1, C A Fijen, M T te Bulte
1Universiteit van Amsterdam en Rijksinstituut voor Volksgezondheid en Milieuhygiëne, Referentielaboratorium voor Bacteriële Meningitis, Amsterdam.
Nederlands Tijdschrift Voor Geneeskunde
|June 5, 1993
Summary
Survivors of meningococcal infections, especially those with serogroups X, Y, W135, or non-groupable strains, have a high prevalence of complement deficiencies. Screening for these deficiencies is recommended in at-risk patients to prevent recurrent infections.
Area of Science:
- Immunology
- Infectious Diseases
- Genetics
Background:
- Neisseria meningitidis infections can lead to severe outcomes, including death.
- The complement system plays a crucial role in host defense against bacterial infections.
- Complement deficiencies are known risk factors for invasive meningococcal disease.
Purpose of the Study:
- To investigate the prevalence of complement system deficiencies in individuals who have recovered from Neisseria meningitidis infection.
- To identify specific meningococcal serogroups associated with a higher risk of complement deficiencies.
- To determine the types and distribution of complement pathway defects in survivors.
Main Methods:
- A retrospective study design was employed.
- 187 patients with a history of meningococcal infection between 1959-1990 were selected.
- Complement activity was assessed using haemolysis in gel and free solution assays.
Main Results:
- Overall, 18% of meningococcal infection survivors exhibited complement deficiencies.
- Patients older than 10 years infected with serogroups X, Y, W135, or non-groupable strains showed the highest prevalence (45%).
- Properdin (39%) and C8 (18%) deficiencies were most common, with terminal complement pathway defects linked to recurrent meningitis.
Conclusions:
- A significant proportion of Neisseria meningitidis survivors have complement deficiencies.
- Screening for complement deficiency is warranted in patients with infections caused by serogroups X, Y, W135, or non-groupable strains.
- Identifying complement deficiencies can aid in managing patients at risk for recurrent meningococcal disease.