Evidence map›Paper›PMID 32972440›Full record

ArticlePediatric rheumatology online journal2020

Bacterial infections in a pediatric cohort of primary and acquired complement deficiencies.

Taha Al-Shaikhly, Kristen Hayward, Matthew L Basiaga, Eric J Allenspach

Open access · goldAbstract read
In one paragraph

Article in Pediatric rheumatology online journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 89% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Taha Al-ShaikhlyDivision of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, Penn State College of Medicine, Hershey, PA, USA.
Kristen HaywardDivision of Rheumatology, Department of Pediatrics, University of Washington, Seattle, WA, 98101, USA.
Matthew L BasiagaDivision of Pediatric Rheumatology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.
Eric J AllenspachDivision of Rheumatology, Department of Pediatrics, University of Washington, Seattle, WA, 98101, USA. eric.allenspach@seattlechildrens.org.ORCID http://orcid.org/0000-0001-7346-5835
University of Washington · USMayo Clinic · USPenn State Milton S. Hershey Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcquired complement deficiency can occur in the setting of autoimmune syndromes, such as systemic lupus erythematosus (SLE), with very low or, occasionally, undetectable C3 levels. Based on inherited complement defects, patients with transiently low complement may be at similar risk for serious bacterial infection, but the degree of risk related to C3 level and temporal association is unknown.

methodsWe performed a retrospective study including pediatric patients with undetectable total complement activity or absent individual complement components measured at our institution from 2002 to 2018. We assessed annual rate of serious bacterial infection (SBI) defined as requiring hospitalization and/or parenteral antibiotics by manual chart review. Among included SLE patients, we assessed the 30-day probability of SBI for given C3 measurements using a logistic regression model to determine risk. Primary complement deficiency was analyzed for SBI rate as comparison. Covariates included age, level of immune suppression and history of lupus nephritis.

resultsAcquired complement deficiency secondary to SLE-related disease [n = 44] was the most common underlying diagnosis associated with depressed complement levels and were compared to a cohort of primary complement deficient patients [n = 18]. SBI per 100 person-years and cohort demographics were described in parallel. Our logistic regression analysis of pediatric patients with SLE showed low C3 level was temporally associated with having an SBI event. Given equivalent immunosuppression, patients with an SBI had lower C3 levels at the beginning of the observation period relative to patients without SBI.

conclusionPediatric patients with the diagnosis of SLE can develop very low C3 levels that associate with risk of serious bacterial infection comparable to that of patients with primary complement deficiency. Patients prone to severe complement consumption may particularly be at risk.

Indexed as

Administration, IntravenousAdolescentAnti-Bacterial AgentsBacterial InfectionsChildChild, PreschoolCohort StudiesComplement C3FemaleHereditary Complement Deficiency DiseasesHospitalizationHumansImmunocompromised HostImmunosuppressive AgentsLupus Erythematosus, SystemicLupus NephritisAnti-Bacterial AgentsComplement C3Immunosuppressive AgentsComplementConnective tissue diseaseSLESystemic lupus Erythematosus

Identifiers

PMID32972440
PMCPMC7513499
OpenAlexW3088654086

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.