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Ann Thorac Surg 1991;52:541-543
© 1991 The Society of Thoracic Surgeons

Articles

Complement activation during bypass in acquired C1 esterase inhibitor deficiency

Robert S. Bonser, MRCP, FRCS(C/Th)*, Jitendra Dave, FIMLS, John Morgan, MRCP, Cliff Morgan, FFARCS, Edward Davies, FIMLS, Paul Taylor, FIMLS, Harold Gaya, FRCPath, Lindsay John, FRCS, Matthias Paneth, FRCS, Diego Vergani, MD

The Brompton Hospital and King's College Hospital, London, United Kingdom

Accepted for publication January 16, 1991.

* Address reprint requests to Mr Bonser, Queen Elizabeth Hospital, Queen Elizabeth Medical Centre, Birmingham B15 2TH, United Kingdom.

Serial complement estimations during cardiopulmonary bypass are reported in a patient with acquired C1 esterase inhibitor deficiency. Although the extent of classic and alternative pathway activation appeared appropriate, exaggerated common pathway activation with massive increase in the C3d:C3 ratio occurred. A fatal hemostatic disorder, pulmonary edema, and circulatory collapse ensued despite prophylaxis and therapy.




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