Meningococcal septicaemia in a C6-deficient patient and effects of plasma transfusion on lipopolysaccharide release

Patients whose blood is deficient in the terminal component of complement have an increased susceptibility to meningococcal infection. However, mortality from meningococcal infection is lower in these patients than in immunocompetent subjects. We studied a C6-deficient patient with meningococcal sep...

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Bibliographic Details
Published in:The Lancet (British edition) 1992-12, Vol.340 (8832), p.1379-1381
Main Authors: Lehner, P.J., Cohen, J., Davies, K.A., Walport, M.I., Cape, A.P., Wurzner, R., Orren, A., Morgan, B.P.
Format: Article
Language:English
Subjects:
Adult
Bacteremia - immunology
Bacteremia - mortality
Blood
Blood Bactericidal Activity
Blood Component Transfusion
Complement C6 - deficiency
Complement Membrane Attack Complex - immunology
E coli
Endotoxins
Endotoxins - metabolism
Escherichia coli - metabolism
Female
Humans
Lipopolysaccharides - blood
Medical research
Meningitis, Meningococcal - immunology
Meningitis, Meningococcal - mortality
Mortality
Neisseria meningitidis - immunology
Plasma
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Summary:Patients whose blood is deficient in the terminal component of complement have an increased susceptibility to meningococcal infection. However, mortality from meningococcal infection is lower in these patients than in immunocompetent subjects. We studied a C6-deficient patient with meningococcal sepsis who received fresh frozen plasma (FFP). The patient's initial plasma endotoxin, C6, and terminal-complement-complex concentrations were low, but rose sharply after treatment with FFP. Samples of the patient's serum taken shortly after admission did not cause endotoxin release from Escherichia coli J5 in vitro, but endotoxin-releasing activity was restored in serum samples taken after infusion of FFP. It is possible that C6-deficient patients have reduced mortality from meningococcal infection because their serum cannot cause acute release of endotoxin from the invading organism and extensive tissue damage is thus avoided.
ISSN:0140-6736
1474-547X
DOI:10.1016/0140-6736(92)92561-S