Recurrent Meningococcemia Associated with IgG<sub>2</sub>-Subclass Deficiency

Jl, Bass; Nuss, Rachelle; Ka, Mehta; Morganelli, Peter M.; Bennett, Lesley

doi:10.1056/nejm198308183090711

Cited by 30 publications

(3 citation statements)

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“…Multiple publications demonstrated the association between IgG2 subclass deficiency and infections with encapsulated organisms as Streptococcus pneumoniae [ 22 , 23 ] and Haemophilus influenzae [ 24 ]. We speculate that the IgG2 deficiency may have predisposed individuals to infection with this heavily encapsulated strain of K pneumonia .…”

Section: Discussionmentioning

confidence: 99%

Hypermucoviscous Klebsiella Syndrome Without Liver Abscess in a Patient With Immunoglobulin G2 Immune Deficiency

Alsaedi¹,

Janower²,

Wang³

et al. 2014

Open Forum Infectious Diseases

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Background Hypermucoviscous Klebsiella pneumoniae (HMVKP) emerged as a cause of invasive infections in South-East (SE) Asia. It has become the most common cause of liver abscess in that region, and it is a significant causative organism in endogenous endophthalmitis and meningitis. During the past decade, cases of this uniquely virulent organism have been reported outside of SE Asia, with a propensity to affect individuals of SE Asian descent. Cases have been reported from North America including Canada.Methods We report a case of a patient of Filipino descent living in Canada who presented with recurrent HMVKP bacteremia in the absence of pyogenic liver abscess or other localized metastatic Klebsiella infection.Results Investigations identified an immunoglobulin (Ig)G2 deficiency and low IgM indicating potential common variable immunodeficiency, and administration of intravenous immunoglobulins was associated with prevention of further recurrences.Conclusions To our knowledge, this is the first report of HMVKP associated with predisposing antibody deficiency.

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Section: Discussionmentioning

confidence: 99%

Hypermucoviscous Klebsiella Syndrome Without Liver Abscess in a Patient With Immunoglobulin G2 Immune Deficiency

Alsaedi¹,

Janower²,

Wang³

et al. 2014

Open Forum Infectious Diseases

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“…Invasive meningococcal disease (IMD) is a rare condition (1.2 million cases per year worldwide, ca 15-20 cases per 100,000 population) with a high case fatality rate (worldwide more than 10%) [1]. While most affected patients suffer from only a single episode in their life span, there is anecdotal evidence for recurrent infection [2][3][4]. It is known that the prevalence of complement deficiencies is especially high in patients with recurrent IMD [5][6][7] but there are also reports of recurrent IMD associated with Waldenström's disease [2], chronic glomerulonephritis [3] and IgG2-subclass deficiency [4].…”

Section: Introductionmentioning

confidence: 99%

“…While most affected patients suffer from only a single episode in their life span, there is anecdotal evidence for recurrent infection [2][3][4]. It is known that the prevalence of complement deficiencies is especially high in patients with recurrent IMD [5][6][7] but there are also reports of recurrent IMD associated with Waldenström's disease [2], chronic glomerulonephritis [3] and IgG2-subclass deficiency [4]. Host predisposition inside and outside the complement system seems to play an important role in the aetiology of IMD [8,9].…”

Section: Introductionmentioning

confidence: 99%

Recurrent invasive meningococcal infections – quantifying the risk, Germany, 2002 to 2018

et al. 2020

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Invasive meningococcal disease (IMD) is a rare condition with a high case fatality rate. While most patients suffer from one single episode in life, there is anecdotal evidence for recurrent infection. Aim: The German National Reference Laboratory for Meningococci and Haemophilus influenzae (NRZMHi) analysed IMD cases from 2002 to 2018 to retrospectively quantify the risk of recurrent infection. Methods: Recurrent IMD was defined as detection of Neisseria meningitidis in a sample of the same patient more than 30 days after the first episode of IMD. Results: Among 5,854 patients with a median observation period of 9.4 years, 14 suffered a second IMD episode and one patient a third one. The risk of a recurrent IMD was 29.4 per 100,000 person-years for survivors of the first episode. Rare serogroups (Y, W, E and Z) were more common in patients with recurrent IMD (p < 0.0001). Discussion: Patients surviving IMD were at least at a 50-fold risk of another IMD episode compared with the general population. The study most likely underestimated the risk of recurrent infection. Increased risk may be due to undiagnosed complement deficiencies. The high risk of re-infection argues for vaccination of patients who have survived IMD. License, supplementary material and copyright This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence and indicate if changes were made.

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C5 deficiency and meningitis in a Swiss family

Gianella‐Borradori¹

1988

Archives of Internal Medicine

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Recurrent Meningococcemia Associated with IgG₂-Subclass Deficiency

Cited by 30 publications

References 11 publications

Hypermucoviscous Klebsiella Syndrome Without Liver Abscess in a Patient With Immunoglobulin G2 Immune Deficiency

Hypermucoviscous Klebsiella Syndrome Without Liver Abscess in a Patient With Immunoglobulin G2 Immune Deficiency

Recurrent invasive meningococcal infections – quantifying the risk, Germany, 2002 to 2018

C5 deficiency and meningitis in a Swiss family

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Recurrent Meningococcemia Associated with IgG2-Subclass Deficiency

Cited by 30 publications

References 11 publications

Hypermucoviscous Klebsiella Syndrome Without Liver Abscess in a Patient With Immunoglobulin G2 Immune Deficiency

Hypermucoviscous Klebsiella Syndrome Without Liver Abscess in a Patient With Immunoglobulin G2 Immune Deficiency

Recurrent invasive meningococcal infections – quantifying the risk, Germany, 2002 to 2018

C5 deficiency and meningitis in a Swiss family

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Recurrent Meningococcemia Associated with IgG₂-Subclass Deficiency