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Seroprotection for Diphtheria, Pertussis, Tetanus and Measles in Children With Nephrotic Syndrome

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Abstract

Objective

To determine seroprotective titres for diphtheria, pertussis, tetanus and measles in children with nephrotic syndrome who had received essential immunization.

Methods

Children (2–18 years) with steroid sensitive nephrotic syndrome (SSNS) or steroid-resistant nephrotic syndrome (SRNS) who were in disease remission and had received essential childhood immunization were included. Anti-diphtheria, anti-pertussis, anti-tetanus and anti-measles antibody titres were measured.

Results

Seventy-six (40 with SSNS; 36 with SRNS) children with mean (SD) age 7.54 (3.96) years were enrolled. The time elapsed since last vaccination was >5 years in 68.4% patients. The seroprotection rates for diphtheria, tetanus, pertussis, and measles were 86.8%, 93.4%, 31.6% and 77.6% respectively; lower in SRNS subjects compared to SSNS. Robust seroprotection titers (1.0 IU/mL) for diphtheria were seen in 23.8% SSNS and 17.9% SRNS; P=0.04, and for tetanus in 69.3% SSNS and 43.8% of SRNS subjects; P=0.03, respectively.

Conclusions

Children with nephrotic syndrome especially those with SRNS have lower seroprotective titers for diphtheria, tetanus, pertussis and measles, necessitating a booster dose of DPT/DT/Td and MR/MMR.

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References

  1. Kemper MJ, Altrogge H, Ganeshow R, Wiefel DE. Serum levels of immunoglobulins and IgG subclasses in steroid sensitive nephrotic syndrome. Pediatr Nephrol. 2002;17:413–7.

    Article  Google Scholar 

  2. Han JW, Lee KY, Hwang JY, Koh DK, Lee J. Antibody status in children with steroid sensitive nephrotic syndrome. Yonsei Med J. 2010;51:239–43.

    Article  CAS  Google Scholar 

  3. Kwon HJ, Lee JW, Chung NG, et al. Assessment of serologic immunity to Diphtheria-Tetanus-Pertussis after treatment of Korean Pediatric hematology and oncology patients. J Korean Med Sci. 2012;27:78–83.

    Article  CAS  Google Scholar 

  4. Moss WJ, Clements CJ, Halsey NA. Immunization of children at risk of infection with human immunodeficiency virus. Bull World Health Org. 2003;81:61–70.

    PubMed  Google Scholar 

  5. Mantan M, Pandharikar N, Yadav S, Chakravarti A, Sethi G R. Sero-protection for hepatitis B in children with nephrotic syndrome. Pediatr Nephrol. 2013;28:2125–30.

    Article  Google Scholar 

  6. Indian Pediatric Nephrology Group, Indian Academy of Pediatrics. Management of Steroid Sensitive Nephrotic Syndrome: Revised Guidelines. Indian Pediatr. 2008;45: 203–14.

    Google Scholar 

  7. Indian Pediatric Nephrology Group, Indian Academy of Pediatrics. Management of Steroid Resistant Nephrotic Syndrome: Revised Guidelines. Indian Pediatr. 2009;46:35–47.

    Google Scholar 

  8. Wharton M, Vitek CR. Diphtheria Toxoid. In: Plotkin S, Orenstien W, Offit P, eds. Vaccines. 6th ed. New York. Elsevier Publications; 2013:757–60.

    Google Scholar 

  9. Wassilak SGF, Roper MH, Murphy TV, Orenstein WA, Tetanus Toxoid. In: Plotkin S, Orenstien W, Offit P, eds. Vaccines. 6th ed. Elsevier Publications; 2013:757-60.

  10. Efstratiou A, Maple PAC. Laboratory diagnosis of diphtheria. 1994 World Health Organization copenhagen expanded programme on immunization in the European region. Accessed March 19, 2018. Available from: https://apps.who.int/iris/handle/10665/108108

  11. Edwards KM, Decker MD. Pertussis Vaccine. In: Plotkin S, Orenstien W, Offit P, eds. Vaccines. 6th ed. Elsevier Publications; 2013:471-528.

  12. Strebel PM, Papania MJ, Neal A, Haslsey NA. Measles vaccine. In: Plotkin S, Orenstien W, Offit P, eds. Vaccines. 6th ed. Elsevier Publications; 2013:389-440.

  13. Murhekar M. Epidemiology of diphtheria in India, 1996–2016: Implications for prevention and control. Am J Trop Med Hyg. 2017;97:313–8.

    Article  Google Scholar 

  14. Sangal L, Joshi S, Ananadan S, et al. Resurgence of diphtheria in North Kerala, India, 2016: Laboratory supported case-based surveillance outcomes. Front Public Health. 2017;5:218.

    Article  Google Scholar 

  15. Chitkara AJ, Parikh R, Mihalyi A, Kolhapure S. Hexavalent vaccines in India: Current Status. Indian Pediatr. 2019;56:939–50.

    Article  Google Scholar 

  16. Tetanus and adult diptheria: Operational guidelines. Ministry of Health and Family Welfare, Government of India. Accessed August 14, 2020. Available from: https://nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Td_vaccine_operational_guidelines.pdf

  17. Heijstek MW, Gageldonk PGM, Berbers GAM, Wulffraat NM. Differences in persistence of measles, mumps, rubella, diphtheria and tetanus antibodies between children with rheumatic disease and healthy controls: A retrospective cross-sectional study. Ann Rheum Dis. 2012;71:948–54.

    Article  CAS  Google Scholar 

  18. Neupane N, Krishnamurthy S, Jagadisan B, Dhodapkar R. Hepatitis B Seroprotection in Pediatric Nephrotic Syndrome. Indian Pediatr. 2019;56:659–62.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Maulana Azad Medical College and associated Lok Nayak Hospital, University of Delhi, New Delhi, 110 002, India

    NoGivenName MAjay, Mukta Mantan, Aashima Dabas & Sangeeta Yadav

  2. Department of Microbiology, Maulana Azad Medical College and associated Lok Nayak Hospital, University of Delhi, New Delhi, India

    Ansar Asraf & Anita Chakravarti

Authors
  1. NoGivenName MAjay
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  2. Mukta Mantan
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  3. Aashima Dabas
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  4. Ansar Asraf
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  5. Sangeeta Yadav
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  6. Anita Chakravarti
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Corresponding author

Correspondence to Mukta Mantan.

Additional information

Ethical clearance

Institutional Ethics Committee of Maulana Azad Medical College; No.11/IEC/MAMC/2015/317, dated November 27, 2015.

Contributors

MM, SY, AC: conceptualization; AM, AA: Methodology; AM, MM, AD: software; AA, MM, SY: validation; AM, AD, MM: formal analysis; AA, AC: investigation; MM, AC: resources; AM, MM, AD: data curation, AM, MM, AD: writing — original draft; AA, MM, AD: writing — review & editing; MM: visualization; MM, SY, AC: supervision; MM, AA: project administration. All authors approved the final version of manuscript, and are accountable for all aspects related to the study.

Funding

Intramural grant from Maulana Azad Medical College

Competing interest

None.

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MAjay, N., Mantan, M., Dabas, A. et al. Seroprotection for Diphtheria, Pertussis, Tetanus and Measles in Children With Nephrotic Syndrome. Indian Pediatr 58, 233–236 (2021). https://doi.org/10.1007/s13312-021-2161-2

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  • DOI: https://doi.org/10.1007/s13312-021-2161-2

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