ESPN 53rd Annual Meeting

ESPN 2021


 
Vaccine titers in children with idiopathic nephrotic syndrome on oral immunosuppressive drugs
CLAIRE HERBEZ REA CLAIRE DOSSIER CYRIELLE PARMENTIER OLIVIA BOYER TIM ULINSKI JEAN-DANIEL DELBET

1- Trousseau Hospital
 
Introduction:

 Infections remain a major complication in children with idiopathic nephrotic syndrome (INS). This study reports post-vaccination antibody levels in patients with steroid dependent and steroid resistant INS treated with oral immunosuppressants. The primary endpoint was a positive antibody titer.

Material and methods:

We carried out a retrospective study in three pediatric nephrology departments. All children with a diagnosis of INS treated with tacrolimus, mycophenolate mofetil or levamisole were included. The post-vaccine Ab titers and the following clinical and biological parameters were analyzed: age at diagnosis of the INS, number of relapses, duration of the INS, duration of immunosuppressive treatment, immunoglobulin levels, time between the last relapse and post-vaccination serologies and time between the last vaccination and serologies.

Results:

Sixty-two patients were included. The median age at INS diagnosis was 4.08 (2.78-7.11) years, the median duration of the INS 3.43 (2.06-7.09) years, the median time between the last relapse and post-vaccination serologies was 1.15 (0.68-2.08) years. 30/62 (48%) patients received calcineurin inhibitors, 44/62 (71%) received mycophenolate mofetil, 15/62 (24%) received both and 11/62 (18%) received levamisole. The percentage of positive vaccine titers for hepatitis B, measles, diphtheria / tetanus and chickenpox were 38%, 66%, 79% and 55%, respectively. A higher number of relapses was associated with a negative antibody titer against hepatitis B.

Conclusions:

Patients with INS treated with oral immunosuppressive therapy have inadequate post-vaccination antibody coverage, which is not correlated with any specific treatment modality. However, the number of relapses appears to be associated with the likelihood of having negative hepatitis B antibody titers.