Serum immunoglobulin E levels in children with idiopathic nephrotic syndrome
Keywords:
idiopathic nephrotic syndrome, prednisone, IgE, allergy
Abstract
Background Children with idiopathic nephrotic syndrome (INS)have been known to have T-cell dysfunction and an impairment of
the cytokine network that may alter glomerular permeability and
the glomerular filtration barrier. This disorder may contribute to the
presence of urinary protein loss in children with INS. The elevation
of serum IgE levels has been noted in some cases, but its associa-
tion with steroid-responsive nephrotic syndrome has not been fully
elucidated.
Objective This study was done to investigate the association be-
tween serum IgE levels prior to prednisone treatment in children
with INS and the outcome of treatment.
Methods A prospective observational study has been conducted
on 22 children with INS. Prednisone therapy was given with a dose
of 60 mg/m 2 body surface area (BSA) for four weeks followed by a
single dose of 40 mg/m 2 BSA every other day for another four
weeks. This protocol was applied for steroid-responsive INS chil-
dren. Children with steroid resistance were given oral cyclophos-
phamide 2 mg/kg for eight weeks. IgE level measurements were
performed prior to prednisone therapy and at remission. Data were
analyzed using one-way ANOVA and multiple regression.
Results Twenty-two children were enrolled in this study. High lev-
els of serum IgE were found in 95.5% of children, with a mean of
2002.5 (SD 2172.1) IU/ml. The serum IgE levels of INS children
with history of allergy were significantly higher than those of neph-
rotic children without history of allergy (P<0.05). However, there
was no significant correlation between the serum IgE levels and
the outcome of treatment in children with INS.
Conclusion The high serum IgE levels in children with INS seem
to be associated with humoral immune disorder and did not have
any association with the outcome of therapy. Even though the se-
rum IgE levels were significantly higher in INS children with history
of allergy, other factors that may influence serum IgE levels must
be considered
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cent approaches to the pathogenesis of minimal-change
nephrotic syndrome. Nephrol Dial Transplant
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S, Goldblatt D, Weemaes CMR, Haraldsson A. Increase
expression of interleukin-13 but not interleukin-4 in
CD4+ cells from patients with the hyper-IgE syndrome.
Clin Exp Immunol 2002;128:532-7.
15. Yanagihara Y. Molecular regulation of human IgE syn-
thesis. Allergology International 1999;48:111-9.
in childhood nephrotic syndrome. Pediatr Nephrol
2003;18:1211-5.
2. Cunard R, Kelly CJ. T cells and minimal change dis-
ease. J Am Soc Nephrol 2002;13:1409-11.
3. Haycock G. The child with idiopathic nephrotic syn-
drome. In: Nicholas JA, editor. Clinical paediatric
nephrology. 3 rd edition. Postlethwaite: Oxford Univer-
sity Press; 2003. p. 341-66.
4. Niaudet P. Steroid-sensitive idiopathic nephrotic syn-
drome in children. In: Avner ED, Harmon WE, Niaudet
P, editors. Pediatric nephrology. 5 th edition. Philadelphia:
Lippincott William & Wilkins; 2004. p. 543-56.
5. Niaudet P. Steroid-resistant idiopathic nephrotic syn-
drome in children. In: Avner ED, Harmon WE, Niaudet
P, editors. Pediatric nephrology. 5 th edition. Philadelphia:
Lippincott William & Wilkins; 2004. p. 558-73.
6. Clark AG, Barratt TM. Steroid-responsive nephrotic
syndrome. In: Barratt TM, Avner ED, Harmon WE,
editors. Pediatric nephrology. 4 th ed. Philadelphia:
Lippincott Williams & Wilkins; 1999. p. 731-47.
7. International Study of Kidney Diseases in Children.
The primary nephrotic syndrome in children. Identi-
fication of patients with minimal change nephrotic syn-
drome from initial response to prednisone. J Pediatr
1981;98:561-4.
8. Cheung W, Wei CL, Seah CC. Atopy, serum IgE, and
interleukin-13 in steroid-responsive nephrotic syn-
drome. Pediatr Nephrol 2004;19:627-32.
9. Schulte-Wissermann H, Gortz W, Straub E. IgE in
patients with glomerulonephritis and minimal-
change nephrotic syndrome. Eur J Pediatr 1979;
131:105-11.
10. Meadow SR, Sarsfield JK, Scott DG, Rajah SM. Ste-
roid-responsive nephrotic syndrome and allergy: im-
munological studies. Arch Dis Child 1981;56:517-24.
11. Durkan A, Hodson E, Willis N, Craig J. Non-corticoster-
oid treatment for nephrotic syndrome in children [abstract].
Cochrane Database Syst Rev 2001;(4):CD002290.
12. Yap HK, Cheung W, Murugasu B, Sim SK, Seah CC,
Jourdan SC. Th1 and Th2 cytokine mRNA profiles in
childhood nephrotic syndrome. J Am Soc Nephrol
1999;10:529-37.
13. Grimbert P, Audard V, Remy P, Lang P, Sahali D. Re-
cent approaches to the pathogenesis of minimal-change
nephrotic syndrome. Nephrol Dial Transplant
2003;18:245-8.
14. Gudmundsson KO, Sigurjonsson OE, Gudmundsson
S, Goldblatt D, Weemaes CMR, Haraldsson A. Increase
expression of interleukin-13 but not interleukin-4 in
CD4+ cells from patients with the hyper-IgE syndrome.
Clin Exp Immunol 2002;128:532-7.
15. Yanagihara Y. Molecular regulation of human IgE syn-
thesis. Allergology International 1999;48:111-9.
Published
2016-10-10
How to Cite
1.
Asmaningsih N, Poernomo W, Noer M. Serum immunoglobulin E levels in children with idiopathic nephrotic syndrome. PI [Internet]. 10Oct.2016 [cited 25Apr.2024];45(2):55-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/799
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Received 2016-10-05
Accepted 2016-10-05
Published 2016-10-10
Accepted 2016-10-05
Published 2016-10-10
