Post-vaccine glomerulonephritis in an infant with hereditary C2 complement deficiency: case study

We describe a case of a post vaccine immune complex-mediated glomerulonephritis in an infant with compound heterozygous mutations of C2 complement component gene, which is the first such case in the literature. The three and a half months old boy presented with clinical and laboratory signs of nephritic syndrome and was successfully treated with methylprednisolone. An explanation of such a clinical picture may lie in the interaction between C2 deficiency and vaccination. Nephritic syndrome may occur at any age, but is an uncommon finding in infants (1-6). It is caused by proliferative changes and inflammation in the glomeruli-proliferative glomerulonephritis (GN), which can be a primary/isolated disease or a consequence of a systemic disease. The most common types of primary proliferative GN in children are post-infectious GN, IgA nephropathy, and membranoproliferative GN, and the most common types of proliferative GN due to a systemic disease are Henoch Schnlein GN and lupus GN (1,5,6). All these conditions are immunologically mediated with in situ immune-complex formation or passive immune-complex trapping in the glomeruli and activation of secondary immune mechanisms like complement system. We describe a case of presumably post-vaccine immune-complex mediated GN in a three and a half months old boy in whom two heterozygous mutations on a C2 complement component gene were found. The possible adverse event after vaccination was reported to the National Institute of Public Health.