[Complement deficiencies and meningococcal disease in The Netherlands].
OBJECTIVE
To determine the prevalence of complement system deficiencies in patients who have survived a Neisseria meningitidis infection.


METHODS
Retrospective.


METHODS
Reference laboratory for bacterial meningitis of the University of Amsterdam and the National Institute of Public Health and Environmental Protection.


METHODS
Out of the files of the laboratory 187 patients who had experienced a meningococcal infection in the Netherlands between 1959-1990 were selected in two groups according to the infecting bacterial strain: 97 patients with a serogroup X, Y, Z, W135, 29E, or non-groupable strains and 90 patients with an infection due to serogroup A or C. The patients were asked for their cooperation by their family doctor and one of us visited the patients at home to take blood samples. The complement activity was studied with a haemolysis in gel test and with an assay of haemolytic activity in free solution.


RESULTS
Complement deficiency was present in 18% of the 187 patients who had experienced a meningococcal infection. The highest prevalence was found in patients older than 10 years who had developed infections due to serogroups X, Y, W135, or non-groupable strains (45%). Of the patients with a serogroup A or C infection, 3% had an complement deficiency. Of the complement deficiencies, 42% concerned a component of the alternative pathway, 12% a deficiency of C3, and 46% a component of the terminal route. The most commonly found deficiencies were properdin deficiency (39%) and C8 deficiency (18%). 30% of the complement deficient patients reported other family members having experienced meningitis. Recurrent meningitis was only observed in patients with terminal route deficiencies.


CONCLUSIONS
We recommend that patients with a meningococcal infection due to serogroups X, Y, W135 or non-groupable strains should be screened for complement deficiency.
Swart
A G
AG
Universiteit van Amsterdam en Rijksinstituut voor Volksgezondheid en Milieuhygiëne, Referentielaboratorium voor Bacteriële Meningitis, Amsterdam.
Fijen
C A
CA
te Bulte
M T
MT
Daha
M R
MR
Dankert
J
J
Kuijper
E J
EJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D003165:Complement System Proteins / Q000172:deficiency*; D005260:Female; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000276:immunology* / Q000382:microbiology; D009345:Neisseria meningitidis / Q000145:classification; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012703:Serotyping
D003165:Complement System Proteins
Complementdeficiënties en meningokokkenziekte in Nederland.