Immunoglobulin G and M levels in childhood nephrotic syndrome

two centers Egyptian study

Authors

  • Ghada Mohamed El Mashad Assistant Professor of Pediatrics, Faculty of Medicine, Menoufia University, Egypt

Keywords:

Nephrotic syndrome, Immunoglobulins, Children

Abstract

Introduction: Idiopathic nephrotic syndrome (INS) is the most common glomerular disease in children. Immune cell subsets may play a role in pathogenesis of INS. We aimed to assess immunoglobulin G (IgG) and immunoglobulin M (IgM) levels in children with nephrotic syndrome (NS) to predict prognosis of the disease and response to treatment.

Methods: This prospective case control study was done in Pediatric Nephrology Units at Minoufia and Benha University Hospitals, during the period from   1st March 2014 to 30th June 2015. Seventy-five children in the active stage of INS and 75 apparently healthy children of matched age and sex were included in this study. Statistical evaluation was performed by SPSS version 18.0 using independent-samples t-test, Chi-square, and Pearson's correlation coefficient (r). 

Results: Compared with healthy children, IgM level was high, IgG level and IgG/IgM ratio were low (p≤0.05). The IgG level and IgG/IgM ratio decreased more in FRNS than in IFRNS group, and was the lowest in SRNS group. The IgM level increased more in FRNS than in IFRNS group, and was the highest in SRNS group (p<0.05, respectively). 

Conclusions: Our findings support the idea that IgG level has a prognostic value in NS in children

References

Tesar V, Zima T, Kalousová M. Pathobiochemistry of nephrotic syndrome. Adv Clin Chem. 2003; 37: 173- 218. doi: 10.1016/S0065-2423(03)37009-X.

Kemper MJ, Zepf K, Klaassen I, Link A, Muller-Wiefel DE. Changes of lymphocyte populations in

pediatric steroid-sensitive NS are more pronounced in remission than in relapse. Am J Nephrol. 2005;

(2): 132-7. doi: 10.1159/000085357. PMID: 15855740

Audard V, Lang P, Sahali D. [Minimal change nephrotic syndrome: new insights into disease

pathogenesis]. Med Sci (Paris). 2008; 24(10): 853-8. doi: 10.1051/medsci/20082410853. PMID: 18950582.

Pereira Wde F, Brito-Melo GE, Guimarães FT, Carvalho TG, Mateo EC, Simões e Silva AC. The role of

the immune system in idiopathic nephrotic syndrome: a review of clinical and experimental studies.

Inflamm Res. 2014; 63(1): 1-12. doi: 10.1007/s00011-013-0672-6. PMID: 24121975.

Han JW, Lee KY, Hwang JY, Koh DK, Lee JS. Antibody status in children with steroid-sensitive nephrotic

syndrome. Yonsei Med J. 2010; 51(2): 239-43. doi: 10.3349/ymj.2010.51.2.239. PMID: 20191016,

PMCID: PMC2824870.

Naseri M. Pneumococcal sepsis, peritonitis, and cellulitis at the first episode of nephrotic syndrome. Iran J

Kidney Dis. 2013; 7(5): 404-6. PMID: 24072154.

Youssef DM, Abdel Salam SM, Karam RA. Prediction of steroid response in nephrotic syndrome by

humoral immunity assessment. Indian J Nephrol. 2011; 21(3): 186-90. doi: 10.4103/0971-4065.82638.

PMID: 21886979, PMCID: PMC3161437.

KDIGO (Kidney disease Improving Global Outcomes): Kidney International Supplements. 2012; 2: 259- 74. doi: 10.1038/kisup.2012.30. PMID: 25018941, PMCID: PMC4089767.

Nariman F, Azat A. Evaluation of Serum (immunoglobulin G, M) in children with nephrotic syndrome

relapse. J Fac Med Baghdad. 2012; 54(1): 15-7.

Stachowski J, Barth C, Michalkiewicz J, Krynicki T, Jarmolinski T, Runowski D, et al. Th1/Th2 balance

and CD45-positive T cell subsets in primary nephrotic syndrome. Pediatr Nephrol. 2000; 14(8-9): 779-85.

doi: 10.1007/PL00013437. PMID: 10955927.

Sahali D, Lang P, Guellaen G, Bensman A. [New insights about immunopathology of lipoid nephrosis].

Bull Acad Nat Med. 2002; 186(3): 683-90. PMID: 12412189.

Ghazala J, Waqar H, Muhammad T, Sajid M. Serum immunoglobulin and complement levels in pediatric

patients of nephrotic syndrome. Pak Ped J. 2000; 24: 139-43.

Araya CE, Wasserfall CH, Brusko TM, Mu W, Segal MS, Johnson RJ, et al. A case of unfulfilled

expectations. Cytokines in idiopathic minimal lesion nephrotic syndrome. Pediatr Nephrol. 2006; 21(5):

-10. doi: 10.1007/s00467-006-0026-5. PMID: 16525836.

Roy RR, Roy E, Rahman MH, Hossain MM. Serum immunoglobulin G, M and IgG: IgM ratio as

predictors for outcome of childhood nephrotic syndrome. World J Pediatr. 2009; 5(2): 127-31. doi:

1007/s12519-009-0025-2. PMID: 19718535.

Sibéril S, Elluru S, Negi VS, Ephrem A, Misra N, Delignat S, et al. Intravenous immunoglobulin in

autoimmune and inflammatory diseases: more than mere transfer of antibodies. Transfus Apher Sci. 2007;

(1): 103-7. doi: 10.1016/j.transci.2007.01.012. PMID: 17765663.

Kemper MJ, Altrogge H, Ganschow R, Müller-Wiefel DE. Serum level of immunoglobulin and IgG

subclasses in steroid sensitive nephritic syndrome. Pediatr Nephrol. 2002; 17(6): 413-7. doi:

1007/s00467-001-0817-7. PMID: 12107805.

Ahmed A, Prasad SK, Afroz Sh, Chowdhury K, Quader MU, Hanif M. Low serum IgG level during

remission: A predictor of frequent relapse nephrotic syndrome. DS (Child) H J. 2011; 27(2): 64-7.

Published

2022-01-18