Abstract
Aim The steroid-responsive form of idiopathic nephrotic syndrome (INS) is the most common chronic kidney disease of childhood. Recurring relapses are responsible for the morbidity in INS. Invasive pneumococcal infections (IPE) are one of the common causes of relapse. To protect against IPE, routine polysaccharide pneumococcal vaccine is recommended. It is thought that the possible immune origin of the disease and the loss of immunoglobulin from the kidneys during relapse, cause the lack of formation of both natural immunity and the immune response to vaccines. In this study, we investigated and compared the antibody response to the 23-valent pneumococcal vaccine in patients with INS and healthy children.
Material and Method A total of 30 patients with steroid-responsive INS (no-relapse: 12, 1-relapse; 7, 2-relapses: 4, 3-relapses: 4, 4-relapses: 2) in remission were included in the study. 24 healthy children, whose ages were similar to the patient group, were included in the control group. None of them had previously vaccinated. They were vaccinated with Pnomo23® vaccine. A 2-fold increase in antibody titer after vaccination was considered adequate response. Total anti-pneumococcal (anti-PCP) IgG levels were measured by ELISA from sera taken before and 6 weeks after vaccination.
Results Six weeks after vaccination, 28 (93.3%) of the INS children and 23 (95.8%) of the healthy children developed an adequate vaccine response. No significant difference was detected between patients with INS and healthy children for the anti-PCP IgG antibody levels measured both before and after vaccination (p>0.05). In the patient group, there were no significant correlation detected in increase of the antibody response rate between cumulative steroid dose and number of the relapses.
Conclusions Pre-vaccine antibody levels were similar in both groups and post-vaccine antibody responses were both adequate and similar. The immune response may not be problematic as thought in patients with steroid-responsive INS while in remission.
