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Serum immunoglobulin G, M and IgG:IgM ratio as predictors for outcome of childhood nephrotic syndrome

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Abstract

Background

Nephrotic syndrome is an immune mediated disorder of the kidney associated with T cell dysfunction and secondary disturbance of B cell with changes in levels of immunoglobulin and IgG:IgM ratio. These changes in immunoglobulin levels can be used as a proxy marker to understand the clinical variety and prognosis of nephrotic syndrome.

Methods

We studied 43 children with nephrotic syndrome during January 2003 to January 2005 in the Pediatric Nephrology Unit, Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Blood samples were collected from the 43 patients, and serum levels of IgG, IgM and IgG:IgM were measured by liquid phase immunoprecipitation assay. Another 20 healthy children attending the laboratory for blood grouping and hepatitis B screening test were enrolled as controls.

Results

In the 43 children with nephrotic syndrome, 24 had steroid sensitive nephrotic syndrome (SSNS) and 19 steroid resistant nephrotic syndrome (SRNS). Compared with healthy children, the IgG level was low, IgM level was high, and IgG:IgM ratio was low (P<0.05). The serum IgG level and IgG:IgM ratio were significantly lower in children with SRNS and in children with frequent relapse (FRNS) combined with steroid dependent nephrotic syndrome (SDNS) than in those with infrequent relapse nephrotic syndrome (IFRNS) (P<0.05, respectively).

Conclusions

Management of different nephrotic syndromes is based on the levels of immunoglobulins along with clinical and biochemical parameters. The decrease of IgG level as a predictive marker for unfavorable prognosis of nephrotic syndrome in children needs further evaluation in larger scale studies.

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Authors and Affiliations

  1. Department of Pediatrics, Nephrology Unit, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

    Ranjit Ranjan Roy, Mohammed Habibur Rahman & Mohammed Moazzam Hossain

  2. International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh

    Eliza Roy

Authors
  1. Ranjit Ranjan Roy
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  2. Eliza Roy
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  3. Mohammed Habibur Rahman
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  4. Mohammed Moazzam Hossain
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Correspondence to Mohammed Moazzam Hossain.

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Roy, R.R., Roy, E., Rahman, M.H. et al. Serum immunoglobulin G, M and IgG:IgM ratio as predictors for outcome of childhood nephrotic syndrome. World J Pediatr 5, 127–131 (2009). https://doi.org/10.1007/s12519-009-0025-2

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  • DOI: https://doi.org/10.1007/s12519-009-0025-2

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