Hereditary properdin deficiency is a rare genetic disorder of the comp
lement system. Three propositi and six additional family members with
properdin deficiency have been found following analysis of the hemolyt
ic activity of the classical (CH50) and the alternative (AP50) complem
ent pathways in the sera of 101 survivors of meningococcal infections
and 59 survivors of severe pneumococcal and Haemophilus influenza infe
ctions. All the properdin-deficient individuals had undetectable level
s of properdin by radial immunodiffusion and by Western blotting. They
belonged to three non-related families of Tunisian Jews who came from
different parts of Tunisia. Two patients had a meningococcal infectio
n at 15 and 16 years of age, respectively, and one had Haemophilus inf
luenza meningitis at 1.5 years of age. In contrast to the fulminant an
d fatal course of meningococcal infection which was previously describ
ed in some properdin-deficient patients, our patients had a relatively
mild disease. Properdin deficiency may not be as rare as previously t
hought. Analysis of AP50, in addition to CH50, in sera of patients who
had meningococcal infection, will probably disclose many more cases o
f hereditary properdin deficiency. In addition, our findings indicate
that, as in other complement abnormalities, hereditary properdin defic
iency may also be associated with the ethnic origin of the patient.