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Pediatric Nephrology
Published in: Pediatric Nephrology 4/2022

01-04-2022 | Nephrotic Syndrome | Original Article

Seroprotection against measles in previously vaccinated children with difficult-to-treat nephrotic syndrome

Authors: Jiten Kumar Sahoo, Soumya Tiwari, Viswas Chhapola, Manoj Jais

Published in: Pediatric Nephrology | Issue 4/2022

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Abstract

Background

Children with nephrotic syndrome (NS) are vulnerable to infections. Measles infection is an important cause of morbidity and mortality in immunosuppressed children. A suboptimal seroprotection against measles has been shown in immunocompromised children. There is limited published literature on measles immunity in children with difficult-to-treat nephrotic syndrome (DTNS). We compared the proportions of children with DTNS and healthy controls who were seroprotected against measles.

Methods

This was a cross-sectional study. Measles-specific IgG antibodies of 108 children with DTNS (3 to 10 years of age) and an equal number of age-matched healthy controls were measured. All children had received two doses of measles-containing vaccine at 9–12 and 16–24 months of age under routine immunisation programme. Serum measles IgG antibody titres were measured by indirect ELISA. The assay results were interpreted as (1) > 11 NTU (NovaTec Units), positive/seroprotective titres; (2) 9–11, equivocal; and (3) < 9 NTU, negative. Inter- and intra-group comparisons were made to identify the disease characteristics related to seroprotection status.

Results

The proportion of children with protective anti-measles antibodies (n = 70, 65%) was significantly lower in DTNS as compared to controls (n = 88, 81.48%) (p = 0.005). Their median [IQR] antibody titres were also significantly lower than those in controls (14.1 [14] NTU vs. 18.3 [15.2] NTU (p = 0.001). The age, gender, clinical subtype, duration of disease, and type of immunosuppressive therapy were not significantly different between seroprotected and non-seroprotected children with DTNS.

Conclusion

A significantly lower percentage of fully vaccinated children with DTNS were seroprotected against measles compared to healthy controls.

Graphical abstract

A higher resolution version of the Graphical abstract is available as Supplementary information.
Appendix
Available only for authorised users
Literature
1.
Mishra OP, Abhinay A, Mishra RN, Prasad R, Pohl M (2013) Can we predict relapses in children with idiopathic steroid-sensitive nephrotic syndrome? J Trop Pediatr 59:343–349CrossRef
2.
Alwadhi RK, Mathew JL, Rath B (2004) Clinical profile of children with nephrotic syndrome not on glucorticoid therapy, but presenting with infection. J Paediatr Child Health 40:28–32CrossRef
3.
Alfakeekh K, Azar M, Sowailmi BA, Alsulaiman S, Makdob SA, Omair A et al (2019) Immunosuppressive burden and risk factors of infection in primary childhood nephrotic syndrome. J Infect Public Health 12:90–94CrossRef
4.
Gulati S, Kher V, Gupta A, Arora P, Rai PK, Sharma RK (1995) Spectrum of infections in Indian children with nephrotic syndrome. Pediatr Nephrol 9:431–434CrossRef
5.
Patel MK, Goodson JL, Alexander JP Jr et al (2020) Progress toward regional measles elimination – Worldwide, 2000–2019. MMWR Morb Mortal Wkly Rep 69:1700–1705CrossRef
6.
7.
Pullan CR, Noble TC, Scott DJ, Wisniewsk K, Gardner PS (1976) Atypical measles infections in leukaemic children on immunosuppressive treatment. Br Med J 1:1562–1565CrossRef
8.
Meadow SR, Weller RO, Archibald RW (1969) Fatal systemic measles in a child receiving cyclophosphamide for nephrotic syndrome. Lancet 294:876–878CrossRef
9.
Breitfeld V, Hashida Y, Sherman FE, Odagiri K, Yunis EJ (1973) Fatal measles infection in children with leukemia. Lab Invest 28:279–291PubMed
10.
Kaplan LJ, Daum RS, Smaron M, McCarthy CA (1992) Severe measles in immunocompromised patients. JAMA 267:1237–1241CrossRef
11.
Schenk J, Abrams S, Theeten H, Van Damme P, Beutels P, Hens N (2021) Immunogenicity and persistence of trivalent measles, mumps, and rubella vaccines: a systematic review and meta-analysis. Lancet Infect Dis 21:286–295CrossRef
12.
Fouda AE, Kandil SM, Boujettif F, Salama YS, Fayea NY (2018) Humoral immune response of childhood acute lymphoblastic leukemia survivors against the measles, mumps, and rubella vaccination. Hematology 23:590–595CrossRef
13.
Rocca S, Santilli V, Cotugno N, Concato C, Manno EC, Nocentini G et al (2016) Waning of vaccine-induced immunity to measles in kidney transplanted children. Medicine (Baltimore) 95:e4738CrossRef
14.
Kerneis S, Launay O, Turbelin C, Batteux F, Hanslik T, Boelle PY (2014) Long-term immune responses to vaccination in HIV-infected patients: a systematic review and meta-analysis. Clin Infect Dis 58:1130–1139CrossRef
15.
Mutsaerts EAML, Nunes MC, van Rijswijk MN, Klipstein-Grobusch K, Otwombe K, Cotton MF et al (2019) Measles immunity at 4.5 years of age following vaccination at 9 and 15–18 months of age among human immunodeficiency virus (HIV)-infected, HIV-exposed-uninfected, and HIV-unexposed children. Clin Infect Dis 69:687–696CrossRef
16.
Indian Pediatric Nephrology Group, Indian Academy of Pediatrics, Bagga A, Ali U, Banerjee S, Kanitkar M, Phadke KD, Senguttuvan P et al (2008) Management of steroid sensitive nephrotic syndrome: revised guidelines. Indian Pediatr 45:203–214
17.
18.
Han JW, Lee KY, Hwang JY, Koh DK, Lee JS (2010) Antibody status in children with steroid-sensitive nephrotic syndrome. Yonsei Med J 51:239–243CrossRef
19.
Ajay M, Mantan M, Dabas A, Asraf A, Yadav S, Chakravarti A (2021) Seroprotection for diphtheria, pertussis, tetanus and measles in children with nephrotic syndrome. Indian Pediatr 58:233–236CrossRef
20.
Deen WM, Bridges CR, Brenner BM, Myers BD (1985) Heteroporous model of glomerular size selectivity: application to normal and nephrotic humans. Am J Physiol 249:F374-389PubMed
21.
Kaysen GA, al Bander H (1990) Metabolism of albumin and immunoglobulins in the nephrotic syndrome. Am J Nephrol 10:36–42CrossRef
22.
Kemper MJ, Altrogge H, Ganschow R, Müller-Wiefel DE (2002) Serum levels of immunoglobulins and IgG subclasses in steroid sensitive nephrotic syndrome. Pediatr Nephrol 17:413–417CrossRef
23.
Baris HE, Baris S, Karakoc-Aydiner E, Gokce I, Yildiz N, Cicekkoku D et al (2016) The effect of systemic corticosteroids on the innate and adaptive immune system in children with steroid responsive nephrotic syndrome. Eur J Pediatr 175:685–693CrossRef
24.
Kemper MJ, Zepf K, Klaassen I, Link A, Muller-Wiefel DE (2005) Changes of lymphocyte populations in pediatric steroid-sensitive nephrotic syndrome are more pronounced in remission than in relapse. Am J Nephrol 25:132–137CrossRef
25.
Ulinski T, Leroy S, Dubrel M, Danon S, Bensman A (2008) High serological response to pneumococcal vaccine in nephrotic children at disease onset on high-dose prednisone. Pediatr Nephrol 23:1107–1113CrossRef
26.
Poyrazoğlu HM, Düşünsel R, Gündüz Z, Patiroğlu T, Köklü S (2004) Antibody response to influenza A vaccination in children with nephrotic syndrome. Pediatr Nephrol 19:57–60CrossRef
27.
Furth SL, Arbus GS, Hogg R, Tarver J, Chan C, Fivush BA, Southwest Pediatric Nephrology Study Group (2003) Varicella vaccination in children with nephrotic syndrome: a report of the southwest pediatric nephrology study group. J Pediatr 142:145–148CrossRef
28.
Marks JS, Halpin TJ, Orenstein WA (1978) Measles vaccine efficacy in children previously vaccinated at 12 months of age. Pediatrics 62:955–960CrossRef
29.
Job JS, John TJ, Joseph A (1984) Antibody response to measles immunization in India. Bull World Health Organ 62:737–741PubMedPubMedCentral
30.
Gupta M, Tripathy JP, Verma M, Singh MP, Kaur R, Ratho RK et al (2019) Seroprevalence of measles, mumps & rubella antibodies among 5–10 years old children in north India. Indian J Med Res 149:396–403CrossRef
31.
Hansashree P, Verma S, Rawat A, Sankhyan N, Bharti B (2018) Long-term seroprotection rates following second dose of measles as MMR vaccine at 15 months in Indian children. Indian Pediatr 55:405–407CrossRef
32.
33.
Papp KA, Haraoui B, Kumar D, Marshall JK, Bissonnette R, Bitton A et al (2019) Vaccination guidelines for patients with immune-mediated disorders taking immunosuppressive therapies: executive summary. J Rheumatol 46:751–754CrossRef
Metadata
Title
Seroprotection against measles in previously vaccinated children with difficult-to-treat nephrotic syndrome
Authors
Jiten Kumar Sahoo
Soumya Tiwari
Viswas Chhapola
Manoj Jais
Publication date
01-04-2022
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 4/2022
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-021-05290-7

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