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Q J Med 1994; 87: 385-401
© 1994 Association of Physicians


research-article

Hereditary complement factor I deficiency

T.J. VYSE, P.J. SPÄTH1, K.A. DAVIES, B.J. MORLEY, P. PHILIPPE2, P. ATHANASSIOU, C.M. GILES and M.J. WALPORT

Rheumatology Unit, RPMS, Hammersmith Hospital London, UK 1ZLB, Central Laboratory, Blood Transfusion Service, SRC Berne, Switzerland 2Regional Hospital Delémont, Delémont Switzerland

Address correspondence to Professor M.J. Walport, Rheumatology Unit, RPMS, Hammersmith Hospital, Du Cane Road, London W12 ONN

Received 17 March 1994 Accepted for publication 13 July 1994.

We describe four cases (from three families) of hereditary factor I deficiency, bringing the total number of cases now reported to 23. In one family there are two affected siblings: one has suffered recurrent pyogenic infections; the other is asymptomatic. In the second family, the patient had recurrent pyogenic infections and a self-limiting vasculitic illness; in the third family, the patient suffered recurrent pyogenic and neisserial infections. All four patients had markedly reduced concentrations of C3 in the serum (family 1 propositus: 28%; family 1 asymptomatic sibling: 15%; family 2: 31%; and family 3: 31 % normal human serum) which was in the form of C3b. Low lgG2 levels may occur in primary C3 deficiency, and reduction in lgG2 concentration to 1.14 g/l (normal: 1.30–5.90 g/l) was found in the patient from family 2. Using radioligand binding assays, we demonstrated increased binding of C3b to erythrocytes in a patient with factor I deficiency. This C3b could not be cleaved by autologous serum but could be cleaved by normal serum or purified factor I. We review and compare the published cases of C3, factor H and factor I deficiency.


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