Format

Send to

Choose Destination
Clin Microbiol Infect. 2017 Aug;23(8):576.e1-576.e5. doi: 10.1016/j.cmi.2017.02.005. Epub 2017 Feb 10.

Diagnosis of primary antibody and complement deficiencies in young adults after a first invasive bacterial infection.

Author information

1
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.
2
CHU Lille, Institut de Microbiologie, Lille, France.
3
Laboratoire de Bactériologie, Centre Hospitalier Gustave Dron, Tourcoing, France.
4
CHU Lille, Département d'Information Médicale, Lille, France.
5
Département d'Information et d'Evaluation Médicale, Centre Hospitalier Gustave Dron, Tourcoing, France.
6
Laboratoire de Bactériologie, Centre Hospitalier Victor Provo, Roubaix, France.
7
CHU Lille, Unité des Maladies Infectieuses, Lille, France.
8
Service Universitaire Régional de Maladies Infectieuses et du Voyageur, Centre Hospitalier Gustave Dron, Tourcoing, France.
9
Service de Réanimation, Centre Hospitalier Gustave Dron, Tourcoing, France.
10
Département d'Information et d'Evaluation Médicale, Centre Hospitalier Victor Provo, Roubaix, France.
11
Service de Pneumologie, Centre Hospitalier Victor Provo, Roubaix, France.
12
CHU Lille, Pôle de Réanimation, Lille, France.
13
CHU Lille, Service de Pneumologie et Immuno-Allergologie, Centre de compétence Maladies Pulmonaires Rares, Lille, France.
14
CHU Lille, Département d'Oncologie Pulmonaire et Thoracique, Lille, France.
15
CHU Lille, Service d'Accueil des Urgences, Lille, France.
16
Univ. Lille, Lille Inflammation Research International Center, Lille, France; CHU Lille, Institut d'Immunologie, Lille, France.
17
Laboratory of Immunology, Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France.
18
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.
19
Hôpital Cochin, Laboratoire d'Immunologie Biologique, Plateforme d'Immuno-Monitoring Vaccinal, Paris, France.
20
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.

Abstract

OBJECTIVES:

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.

CONCLUSION:

PID screening should be considered after a first unexplained invasive encapsulated-bacterial infection in young adults.

KEYWORDS:

Common variable immunodeficiency; Complement deficiency; Group A Streptococcus; Haemophilus influenzae; Immunoglobulin deficiency; Neisseria gonorrhoeae; Neisseria meningitidis; Primary immunodeficiency; Streptococcus pneumoniae

PMID:
28192236
DOI:
10.1016/j.cmi.2017.02.005
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center