Serological responses to immunization during nephrosis in infants with congenital nephrotic syndrome of the Finnish type

BackgroundPretransplant vaccination is generally recommended to solid organ transplant recipients. In infants with congenital nephrotic syndrome (CNS), the immune response is hypothetically inferior to other patients due to young age and urinary loss of immunoglobulins, but data on the immunization...

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Main Authors: Okko Savonius (Author), Anu Kaskinen (Author), Tuula Hölttä (Author), Elisa Ylinen (Author), Juuso Tainio (Author), Tea Nieminen (Author), Timo Jahnukainen (Author)
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Published: Frontiers Media S.A., 2024-05-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Okko Savonius  |e author 
700 1 0 |a Anu Kaskinen  |e author 
700 1 0 |a Tuula Hölttä  |e author 
700 1 0 |a Elisa Ylinen  |e author 
700 1 0 |a Juuso Tainio  |e author 
700 1 0 |a Tea Nieminen  |e author 
700 1 0 |a Timo Jahnukainen  |e author 
245 0 0 |a Serological responses to immunization during nephrosis in infants with congenital nephrotic syndrome of the Finnish type 
260 |b Frontiers Media S.A.,   |c 2024-05-01T00:00:00Z. 
500 |a 2296-2360 
500 |a 10.3389/fped.2024.1392873 
520 |a BackgroundPretransplant vaccination is generally recommended to solid organ transplant recipients. In infants with congenital nephrotic syndrome (CNS), the immune response is hypothetically inferior to other patients due to young age and urinary loss of immunoglobulins, but data on the immunization response in severely nephrotic children remain scarce. If effective, however, early immunization of infants with CNS would clinically be advantageous.MethodsWe investigated serological vaccine responses in seven children with CNS who were immunized during nephrosis. Antibody responses to measles-mumps-rubella -vaccine (MMR), a pentavalent DTaP-IPV-Hib -vaccine (diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Haemophilus influenzae type b), varicella vaccine, combined hepatitis A and B vaccine, and pneumococcal conjugate vaccine (PCV) were measured after nephrectomy either before or after kidney transplantation.ResultsImmunizations were started at a median age of 7 months [interquartile range (IQR) 7-8], with a concurrent median proteinuria of 36,500 mg/L (IQR 30,900-64,250). Bilateral nephrectomy was performed at a median age of 20 months (IQR 14-25), and kidney transplantation 10-88 days after the nephrectomy. Antibody levels were measured at median 18 months (IQR 6-23) after immunization. Protective antibody levels were detected in all examined children for hepatitis B (5/5), Clostridium tetani (7/7), rubella virus (2/2), and mumps virus (1/1); in 5/6 children for varicella; in 4/6 for poliovirus and vaccine-type pneumococcal serotypes; in 4/7 for Haemophilus influenzae type B and Corynebacterium diphtheriae; in 1/2 for measles virus; and in 2/5 for hepatitis A. None of the seven children had protective IgG levels against Bordetella pertussis.ConclusionImmunization during severe congenital proteinuria resulted in variable serological responses, with both vaccine- and patient-related differences. Nephrosis appears not to be a barrier to successful immunization. 
546 |a EN 
690 |a congenital nephrotic syndrome 
690 |a nephrosis 
690 |a vaccine 
690 |a immunization 
690 |a vaccine response 
690 |a children 
690 |a Pediatrics 
690 |a RJ1-570 
655 7 |a article  |2 local 
786 0 |n Frontiers in Pediatrics, Vol 12 (2024) 
787 0 |n https://www.frontiersin.org/articles/10.3389/fped.2024.1392873/full 
787 0 |n https://doaj.org/toc/2296-2360 
856 4 1 |u https://doaj.org/article/8c1a33c42afa4ebf8fa6d9f9128dabf0  |z Connect to this object online.