title: Diagnosis of primary antibody and complement deficiencies in young adults after a first invasive bacterial infection.
abstract: OBJECTIVE
  Screening for primary immunodeficiencies (PIDs) in adults is recommended after two severe bacterial infections. We aimed to evaluate if screening should be performed after the first invasive infection in young adults.
  
  
  METHODS
  Eligible patients were retrospectively identified using hospital discharge and bacteriology databases in three centres during a 3-year period. Eighteen to 40-year-old patients were included if they had experienced an invasive infection with encapsulated bacteria commonly encountered in PIDs (Streptococcus pneumoniae (SP), Neisseria meningitidis (NM), Neisseria gonorrhoeae (NG), Haemophilus influenzae (HI), or group A Streptococcus (GAS)). They were excluded in case of general or local predisposing factors. Immunological explorations and PIDs diagnoses were retrieved from medical records. Serum complement and IgG/A/M testings were systematically proposed at the time of study to patients with previously incomplete PID screening.
  
  
  RESULTS
  The study population comprised 38 patients. Thirty-six had experienced a first invasive episode and a PID was diagnosed in seven (19%): two cases of common variable immunodeficiency revealed by SP bacteraemia, one case of idiopathic primary hypogammaglobulinaemia, and two cases of complement (C6 and C7) deficiency revealed by NM meningitis, one case of IgG2/IgG4 subclasses deficiency revealed by GAS bacteraemia, and one case of specific polysaccharide antibody deficiency revealed by HI meningitis. Two patients had previously experienced an invasive infection before the study period: in both cases, a complement deficiency was diagnosed after a second NM meningitis and a second NG bacteraemia, respectively.
  
  
  CONCLUSIONS
  PID screening should be considered after a first unexplained invasive encapsulated-bacterial infection in young adults.
authors.affiliation: Univ. Lille, Lille Inflammation Research International Center, Lille, France; CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares, Lille, France.
authors.forename: S
authors.initials: S
authors.lastname: Sanges
authors.affiliation: CHU Lille, Institut de Microbiologie, Lille, France.
authors.forename: F
authors.initials: F
authors.lastname: Wallet
authors.affiliation: Laboratoire de Bactériologie, Centre Hospitalier Gustave Dron, Tourcoing, France.
authors.forename: N
authors.initials: N
authors.lastname: Blondiaux
authors.affiliation: CHU Lille, Département d'Information Médicale, Lille, France.
authors.forename: D
authors.initials: D
authors.lastname: Theis
authors.affiliation: Département d'Information et d'Evaluation Médicale, Centre Hospitalier Gustave Dron, Tourcoing, France.
authors.forename: I
authors.initials: I
authors.lastname: Vérin
authors.affiliation: Laboratoire de Bactériologie, Centre Hospitalier Victor Provo, Roubaix, France.
authors.forename: A
authors.initials: A
authors.lastname: Vachée
authors.affiliation: CHU Lille, Institut de Microbiologie, Lille, France.
authors.forename: R
authors.initials: R
authors.lastname: Dessein
authors.affiliation: CHU Lille, Unité des Maladies Infectieuses, Lille, France.
authors.forename: K
authors.initials: K
authors.lastname: Faure
authors.affiliation: Service Universitaire Régional de Maladies Infectieuses et du Voyageur, Centre Hospitalier Gustave Dron, Tourcoing, France.
authors.forename: N
authors.initials: N
authors.lastname: Viget
authors.affiliation: Service Universitaire Régional de Maladies Infectieuses et du Voyageur, Centre Hospitalier Gustave Dron, Tourcoing, France.
authors.forename: E
authors.initials: E
authors.lastname: Senneville
authors.affiliation: Service de Réanimation, Centre Hospitalier Gustave Dron, Tourcoing, France.
authors.forename: O
authors.initials: O
authors.lastname: Leroy
authors.affiliation: Département d'Information et d'Evaluation Médicale, Centre Hospitalier Victor Provo, Roubaix, France.
authors.forename: F
authors.initials: F
authors.lastname: Maury
authors.affiliation: Service de Pneumologie, Centre Hospitalier Victor Provo, Roubaix, France.
authors.forename: N
authors.initials: N
authors.lastname: Just
authors.affiliation: CHU Lille, Pôle de Réanimation, Lille, France.
authors.forename: J
authors.initials: J
authors.lastname: Poissy
authors.affiliation: CHU Lille, Pôle de Réanimation, Lille, France.
authors.forename: D
authors.initials: D
authors.lastname: Mathieu
authors.affiliation: CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de compétence Maladies Pulmonaires Rares, Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Prévotat
authors.affiliation: CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de compétence Maladies Pulmonaires Rares, Lille, France.
authors.forename: C
authors.initials: C
authors.lastname: Chenivesse
authors.affiliation: CHU Lille, Département d'Oncologie Pulmonaire et Thoracique, Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Scherpereel
authors.affiliation: CHU Lille, Service d'Accueil des Urgences, Lille, France.
authors.forename: G
authors.initials: G
authors.lastname: Smith
authors.affiliation: Univ. Lille, Lille Inflammation Research International Center, Lille, France; CHU Lille, Institut d'Immunologie, Lille, France.
authors.forename: B
authors.initials: B
authors.lastname: Lopez
authors.affiliation: Laboratory of Immunology, Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Rosain
authors.affiliation: Laboratory of Immunology, Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France; Complement and diseases team, Cordeliers Research Center, Institut National de la Santé et de la Recherche Médicale, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Frémeaux-Bacchi
authors.affiliation: Univ. Lille, Lille Inflammation Research International Center, Lille, France; CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares, Lille, France.
authors.forename: E
authors.initials: E
authors.lastname: Hachulla
authors.affiliation: Univ. Lille, Lille Inflammation Research International Center, Lille, France; CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares, Lille, France.
authors.forename: P-Y
authors.initials: PY
authors.lastname: Hatron
authors.affiliation: Hôpital Cochin, Laboratoire d'Immunologie Biologique, Plateforme d'Immuno-Monitoring Vaccinal, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Bahuaud
authors.affiliation: Hôpital Cochin, Laboratoire d'Immunologie Biologique, Plateforme d'Immuno-Monitoring Vaccinal, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Batteux
authors.affiliation: Univ. Lille, Lille Inflammation Research International Center, Lille, France; CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares, Lille, France.
authors.forename: D
authors.initials: D
authors.lastname: Launay
authors.affiliation: Univ. Lille, Lille Inflammation Research International Center, Lille, France; CHU Lille, Institut d'Immunologie, Lille, France.
authors.forename: M
authors.initials: M
authors.lastname: Labalette
authors.affiliation: Univ. Lille, Lille Inflammation Research International Center, Lille, France; CHU Lille, Département de Médecine Interne et Immunologie Clinique, Centre National de Référence Maladies Systémiques et Auto-immunes Rares, Lille, France; CHU Lille, Institut d'Immunologie, Lille, France. Electronic address: guillaume.lefevre@chru-lille.fr.
authors.forename: G
authors.initials: G
authors.lastname: Lefèvre
mesh_terms: D000293:Adolescent; D000328:Adult; D016470:Bacteremia / Q000209:etiology* / Q000276:immunology*; D003165:Complement System Proteins / Q000172:deficiency*; D005260:Female; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications* / Q000175:diagnosis*; D007155:Immunologic Factors / Q000172:deficiency; D008297:Male; D008403:Mass Screening / Q000379:methods; D016920:Meningitis, Bacterial / Q000209:etiology* / Q000276:immunology*; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D007155:Immunologic Factors; D003165:Complement System Proteins
keywords: Common variable immunodeficiency; Complement deficiency; Group A Streptococcus; Haemophilus influenzae; Immunoglobulin deficiency; Neisseria gonorrhoeae; Neisseria meningitidis; Primary immunodeficiency; Streptococcus pneumoniae