Insufficient protection by Neisseria meningitidis vaccination alone during eculizumab therapy
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KeywordsComplement System Hemolytic Uremic Syndrome Paroxysmal Nocturnal Hemoglobinuria Eculizumab Meningococcal Disease
Spurred by the reported spectacular results of eculizumab treatment in atypical hemolytic uremic syndrome (aHUS) due to aberrations in the complement system, an increasing number of children will receive this treatment in future. The main adverse effect of this therapy is an increased susceptibility to meningococcal infection due to inhibition of the complement system’s membrane-attack complex. In patients with paroxysmal nocturnal hemoglobinuria treated with eculizumab, the reported occurrence of meningococcal infection is between 0% and 1.5% [1, 2, 3]. These data, concerning adult patients, cannot be extrapolated to children because the age-specific incidence of meningococcal disease is much higher in children.
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- 1.Brodsky RA, Young NS, Antonioli E, Risitano AM, Schrezenmeier H, Schubert J, Gaya A, Coyle L, de Castro C, Maciejewski JP, Bessler M, Kroon HA, Rother RP, Hillmen P (2008) Multicenter phase 3 study of the complement inhibitor eculizumab for the treatment of patients with paroxysmal nocturnal hemoglobinuria. Blood 111:1840–1847PubMedCrossRefGoogle Scholar
- 2.Hillmen P, Elebute M, Kelly R, Urbano-Ispizua A, Hill A, Rother RP, Khursigara G, Fu CL, Omine M, Browne P, Rosse W (2010) Long-term effect of the complement inhibitor eculizumab on kidney function in patients with paroxysmal nocturnal hemoglobinuria. Am J Hematol 85:553–559PubMedCrossRefGoogle Scholar
- 5.Netherlands Reference laboratory for bacterial meningitis (AMC/RIVM). Bacterial Meningitis in the Netherlands; annual report 2009. Amsterdam: University of Amsterdam, 2010Google Scholar
- 7.Memish ZA, Dbaibo G, Montellano M, Verghese VP, Jain H, Dubey AP, Bianco V, Van der Wielen M, Gatchalian S, Miller JM (2011) Immunogenicity of a single dose of tetravalent meningococcal serogroups A, C, W-135, and Y conjugate vaccine administered to 2- to 10-year-olds is noninferior to a licenced-ACWY polysaccharide vaccine with an acceptable safety profile. Ped Infect Dis J 30(4):e56–e62CrossRefGoogle Scholar