脑膜炎球菌病后补体缺陷的调查。
Investigation for complement deficiency following meningococcal disease.
作者信息
Hoare S, El-Shazali O, Clark J E, Fay A, Cant A J
机构信息
Paediatric Infectious Diseases Unit, Newcastle General Hospital, Newcastle upon Tyne, UK.
出版信息
Arch Dis Child. 2002 Mar;86(3):215-7. doi: 10.1136/adc.86.3.215.
BACKGROUND AND AIMS
The incidence of complement abnormalities in the UK is not known. It is suggested in at least three major paediatric textbooks to test for abnormalities of the complement system following meningococcal disease (MCD).
METHODS
Over a four year period, surviving children with a diagnosis of MCD had complement activity assessed. A total of 297 children, aged 2 months to 16 years were screened.
RESULTS
All children except one had disease caused by B or C serogroups. One child, with group B meningococcal septicaemia (complicated by disseminated intravascular coagulation and who required ventilation and inotropic support) was complement deficient. C2 deficiency was subsequently diagnosed. She had other major pointers towards an immunological abnormality prior to her MCD.
CONCLUSION
It is unnecessary to screen all children routinely following MCD if caused by group B or C infection. However, it is important to assess the previous health of the child and to investigate appropriately if there have been previous suspicious infections, abnormal course of infective illnesses, or if this is a repeated episode of neisserial infection.
背景与目的
英国补体异常的发病率尚不清楚。至少有三本主要的儿科教科书建议在患脑膜炎球菌病（MCD）后检测补体系统异常。
方法
在四年期间，对确诊为MCD的存活儿童进行补体活性评估。共筛查了297名年龄在2个月至16岁之间的儿童。
结果
除一名儿童外，所有儿童的疾病均由B或C血清群引起。一名患有B群脑膜炎球菌败血症（并发弥散性血管内凝血，需要通气和使用血管活性药物支持）的儿童存在补体缺陷。随后诊断为C2缺陷。在患MCD之前，她还有其他指向免疫异常的主要指标。
结论
如果MCD由B或C群感染引起，对所有儿童进行常规筛查是不必要的。然而，评估儿童以前的健康状况并在有既往可疑感染、感染性疾病异常病程或这是奈瑟菌感染的复发情况时进行适当调查是很重要的。
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