UNASSIGNED: We 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.
UNASSIGNED: Immunizations 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.
UNASSIGNED: Immunization 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.
■我们调查了在肾病期间免疫的7名中枢神经系统儿童的血清学疫苗反应。对麻疹-腮腺炎-风疹疫苗(MMR)的抗体反应,五价DTaP-IPV-Hib-疫苗(白喉,破伤风,无细胞百日咳,灭活脊髓灰质炎病毒,b型流感嗜血杆菌),水痘疫苗,甲型肝炎和乙型肝炎联合疫苗,和肺炎球菌结合疫苗(PCV)在肾移植之前或之后的肾切除术后进行测量。
■在中位年龄7个月[四分位距(IQR)7-8]开始免疫接种,并发中位蛋白尿为36,500mg/L(IQR30,900-64,250)。双侧肾切除术的中位年龄为20个月(IQR14-25),肾切除术后10-88天进行肾移植。在免疫后的中位18个月(IQR6-23)测量抗体水平。在所有接受检查的乙型肝炎儿童中检测到保护性抗体水平(5/5),破伤风梭菌(7/7),风疹病毒(2/2),和腮腺炎病毒(1/1);水痘5/6儿童;脊髓灰质炎病毒和疫苗型肺炎球菌血清型4/6;B型流感嗜血杆菌和白喉棒状杆菌4/7;麻疹病毒1/2;甲型肝炎2/5。
■严重的先天性蛋白尿期间的免疫导致可变的血清学反应,与疫苗和患者相关的差异。肾病似乎不是成功免疫的障碍。