Mesangiocapillary glomerulonephritis associated with meningococcal meningitis, C3 nephritic factor and persistently low complement C3 and C5.
We report two unusual cases in which mesangiocapillary glomerulonephritis occurred in association with meningococcal infection. C3 nephritic factor, an autoantibody to alternate pathway C3 convertase, was present. Low serum complement C3 and C5 levels were also noted. The depressed complement levels, in conjunction with terminal complement complexes at the upper limit of normal, suggest activation of the early and late complement cascade. We suggest that children presenting with meningococcal infection should have a regular urine examination, as well as full complement measurements performed, in view of the association with hypocomplementaemic mesangiocapillary glomerulonephritis. Similarly, prophylactic penicillin should be prescribed for patients with mesangiocapillary glomerulonephritis and persistently low C5 levels to prevent meningococcal complications.
Hulton
S A
SA
Department of Paediatric Nephrology, Institute of Child Health, London, UK.
Risdon
R A
RA
Dillon
M J
MJ
D000293:Adolescent; D003176:Complement C3 / Q000032:analysis*; D003178:Complement C3 Nephritic Factor / Q000032:analysis*; D003182:Complement C5 / Q000032:analysis*; D015432:Glomerulonephritis, Membranoproliferative / Q000097:blood* / Q000209:etiology; D006801:Humans; D008297:Male; D008585:Meningitis, Meningococcal / Q000097:blood* / Q000150:complications*
D003176:Complement C3; D003178:Complement C3 Nephritic Factor; D003182:Complement C5