PDF(Pubmed)
Abstract：
UNASSIGNED: Pretransplant 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.
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.
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.
摘要：
■移植前疫苗接种通常推荐给实体器官移植受者。在先天性肾病综合征（CNS）的婴儿中，由于年轻和尿中免疫球蛋白的丢失，免疫反应假设不如其他患者，但是关于严重肾病儿童免疫反应的数据仍然很少。如果有效,然而,在临床上对CNS婴儿进行早期免疫将是有利的.
■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。
■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。
