Comparative long-term adverse effects elicited by invasive group B and C meningococcal infections.

• Published in: Clinical Infectious Diseases
• Main Authors: Gottfredsson, Magnus, Reynisson, Ingi K, Ingvarsson, Ragnar F, Kristjansdottir, Hafrun, Nardini, Martina V, Sigurdsson, Jon F, Schneerson, Rachel, Robbins, John B, Miller, Mark A
• Other Authors: Department of Medicine, Landspitali The National University Hospital of Iceland, Reykjavik, Iceland. [e-mail]
• Format: Article in Journal/Newspaper
• Language: English
• Published: Oxford University Press 2011
• Subjects: Adolescent; Adult; Antibodies; Bacterial; Arthritis; Autoimmune Diseases; Child; Preschool; Female; Follow-Up Studies; Humans; Iceland; Immunoglobulin G; Male; Meningitis; Meningococcal; Middle Aged; Migraine Disorders; Nervous System Diseases; Questionnaires; Retrospective Studies; Young Adult
• Online Access: http://hdl.handle.net/2336/225012; https://doi.org/10.1093/cid/cir500

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field. BACKGROUND: Given the identity between Neisseria meningitidis serogroup B (MenB) capsular polysaccharide (polysialic acid; PSA) and PSA found on neural cell adhesion molecules, it has been proposed that infection with MenB or vaccination with PSA may be associated with subsequent autoimmune or neurological disease. METHODS: We conducted 2 studies. The first was a retrospective nationwide study of invasive meningococcal disease (IMD) in Iceland (with 541 subjects) during the period 1975-2004, and we cross referenced this cohort with databases with respect to subsequent diagnosis of autoimmune disorders. A follow-up study involving 120 survivors of IMD was performed. The study included 70 patients with a history of MenB and 50 patients with N. meningitidis serogroup C (MenC) infection, who served as control subjects. Participants answered standardized questionnaires (Beck's Depression Inventory [BDI] II, Depression Anxiety Stress Scales [DASS], and Patient Health Questionnaire [PHQ]), and serum levels of immunoglobulin (Ig) G against MenB and MenC capsular polysaccharides were measured. RESULTS: The nationwide cohort had 9166 patient-years of follow up. No evidence of increased autoimmunity was found to be associated with MenB, compared with MenC. In the follow-up study, patients were evaluated 16.6 years after the infection, representing 2022 patient-years of observation. Comparable rates of most complications were recorded, but MenC infections were associated with arthritis (P = .008) and migraine headaches (P = .01) more frequently than were MenB infections. No difference was observed with respect to scores on BDI-II, DASS, or PHQ. IgG anti-MenB and anti-MenC capsular polysaccharide levels were not related to patient complaints. CONCLUSIONS: This study does not support the hypothesis that MenB infection may predispose to autoimmunity. MenC infections are associated with a higher prevalence of ...