COMPLEMENT FACTOR-I DEFICIENCY WITH RECURRENT ASEPTIC-MENINGITIS

Patients with deficiency of the complement regulatory protein factor I typically present with systemic pyogenic bacterial infections, includ ing meningitis. We report a novel case with total deficiency of factor I in serum and plasma; the patient experienced nine consecutive episo des of aseptic meningitis within a 2-year period. There was no history of previous bacterial sepsis. Aseptic meningitis recurred despite att empted penicillin prophylaxis. Each episode resolved rapidly without s equelae, with or without antibiotic treatment. Serum complement profil es showed persistently low levels of C3, factor B, and factor H and un detectable factor I protein. Family complement studies could not be pe rformed. Except for a minimally increased titer of antinuclear antibod y, no other immunologic abnormality was detected. Results of an oral i buprofen challenge were negative. We conclude that deficiency of facto r I may predispose to aseptic, as well as pyogenic bacterial, meningit is.