Abstract
Sirs, Infection is a known complication of chronic hypocomplementaemia. Patients with C3 deficiency are prone to a number of infections including pneumonia, bacteraemia, meningitis and osteomyelitis caused by encapsulated pyogenic bacteria. Persistently low C3 complement levels are a feature of several renal diseases including membranoproliferative glomerulonephritis (MPGN) and systemic lupus erythematosis [1, 2, 3]. We have followed nine children with low C3 and MPGN over the past 48 cumulative patient years. Two of these children have developed meningococcal septicaemia whose early detection and diagnosis may be difficult in children with known vasculitis. Prior to the septicaemia, both children were well, clinically not nephrotic and receiving ACE inhibitors, low dose day steroids (10 mgms alternate days). One child had a non-groupable meningococcus and the other neisseria meningitidis type W135. Both responded well to intravenous antibiotics and made good clinical recoveries. A small survey of pediatric nephrology colleagues revealed that four of five questioned had experienced meningococcal septicemia in children with chronic C3 depletion. We submit this letter to generate discussion regarding this association. Have other pediatric nephrology units had similar experience? Should we warn parents of the association? Should we recommend meningococcal C and pneumococcal vaccines for children who are chronically hypocomplementaemic? We would appreciate opinions regarding this infrequent association.
Published Version
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