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Rheumatology 2007 46(10):1612-1614; doi:10.1093/rheumatology/kem207
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Clinical variability and characteristic autoantibody profile in primary C1q complement deficiency

G. Vassallo, R. W. Newton, S. E. Chieng1, M. R. Haeney2, A. Shabani3 and P. D. Arkwright4

Department of Paediatric Neurology, 1Department of Rheumatology, Royal Manchester Children's Hospital, Hospital Rd, Manchester, M26 4HA, 2Department of Immunology, Hope Hospital, Stott Lane, Manchester, M6 8HD, 3Department of Radiology and 4Department of Immunology, Royal Manchester Children's Hospital, Hospital Rd., Manchester, M26 4HA, UK.

Correspondence to: Dr Peter Arkwright, Booth Hall Children's Hospital, Charlestown Rd, Blackley, Manchester, M9 7AA, UK. E-mail: peter_arkwright{at}lineone.net


   Abstract

Objectives. C1q deficiency is a rare inherited defect in the early part of the complement cascade. In this report, we describe the varied clinical features of patients with this condition as well as the characteristic autoantibody profile.

Methods. A large Pakistani family with a high degree of consanguinity is described in which the father and five sons have C1q deficiency, all with different clinical manifestations.

Results. Clinical features of C1q deficiency can vary from almost no disease to fulminant bacterial infection and localized lupus-like skin, renal or CNS disease. Autoantibodies to ribonucleoproteins such as anti-Sm and Ro, but not dsDNA, were present.

Conclusions. Awareness of the spectrum of clinical disease, autoantibody profiles and tests required to confirm the diagnosis of C1q deficiency are important if this life-threatening immunodeficiency disease is to be managed correctly.

KEY WORDS: C1q, Complement, SLE, Vasculitis, Meningitis

Submitted 20 May 2007; revised version accepted 2 July 2007.
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