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Meningococcal meningitis in two patients with primary antibody deficiency treated with replacement intravenous immunoglobulin
  1. S Lear1,
  2. E Eren1,
  3. J Findlow2,
  4. R Borrow2,
  5. D Webster1,
  6. S Jolles3
  1. 1Department of Clinical Immunology, Royal Free Hospital, London, UK
  2. 2Vaccine Evaluation Department, Health Protection Agency North West, Manchester, UK
  3. 3Department of Biochemistry and Immunology, University Hospital of Wales, Cardiff, UK
  1. Correspondence to:
    S Jolles
    Department of Biochemistry and Immunology, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK; stephen.jolles{at}


The current treatment of primary antibody deficiency (PAD) is the early recognition of the condition and replacement immunoglobulin combined with prompt treatment of infections and complications. The route of administration (intravenous or subcutaneous), dose and frequency of administration of immunoglobulin still vary between centres and countries. Most infections in patients with PAD are reduced but not entirely prevented by replacement immunoglobulin, with sinopulmonary infections accounting for the bulk of the remainder. Although there have been reports of meningitis in patients with PAD before replacement treatment, we describe the first two cases of bacterial meningitis (group B Neisseria meningitidis) on adequate immunoglobulin replacement and discuss the involvement of potential cofactors.

  • CSF, cerebrospinal fluid
  • MBL, mannan-binding lectin
  • PAD, primary antibody deficiency

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  • Competing interests: None declared.

  • Patient consent was received for publication of this study.