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October 1, 1982

Neisseria meningitidis Serogroup W135 Disease

JAMA. 1982;248(13):1581. doi:10.1001/jama.1982.03330130029019

To the Editor.—  The recent report by Brandstetter et al (1981;246:2060) of Neisseria meningitidis serogroup W135 disease in adults included two patients who had systemic lupus erythematosus (SLE) who were receiving corticosteroids. In most cases, susceptibility to meningococcal disease is due to a selective deficiency of antibody against the infecting strain; there have been little data to support the concept that generalized immunoglobulin deficiency1 or immunosuppressive drugs predispose to meningococcal disease. However, deficiencies in IgM2 or IgA3 and splenectomy (possibly related to low serum IgM levels) may increase susceptibility. I described4 four patients who had meningococcemia caused by serogroup W135. Three of these patients had immunoglobulin deficiency and one had been receiving chlorambucil and prednisone because of chronic lymphocytic leukemia. Another immunocompromised patient with multiple myeloma and serogroup W135 pneumonia has been described recently.5 In addition, a seventh immunocompromised patient in whom W135 bacteremia