Adv Mol Med 2007; 3(4): 177-181

Published online: June 7, 2008
DOI 10.2399/amm.07.177

The early and late response of pneumococcal vaccination in nephrotic children


Harika Alpay, Neşe Karaaslan Bıyıklı, Tunç Akkoç, İbrahim Gökçe, Nihal Özdemir, Nurdan Yıldız


Marmara University School of Medicine, Department of Pediatric Nephrology, Istanbul, Turkey


Objectives: Pneumococcal infection is frequent and severe in patients with nephrotic syndrome (NS). Pneumococcal polysaccharide vaccine is recommended for nephrotic children older than 2 years of age. The aim of our study is to assess the clinical and laboratory efficiacy and side effects of pneumococcal polysaccharide vaccine in NS patients.

Methods: 27 children with steroid responsive NS and 20 controls were enrolled in the study. A 23 valent pneumococcal polysaccharide vaccine was used for vaccination. Blood samples were obtained before and 4 weeks and 3 years after vaccination. ELISA test was used to quantitate serum total antipneumococcal capsule polysaccharide immunoglobulin G antibodies. Antibody levels before vaccination, 4 weeks and 3 years after vaccination were compared.

Results: The mean age of the nephrotic children and controls were 7.8±3.1 years and 8.6±2.6 years, respectively. Baseline antibody titers and antibody titers following 4 weeks and 3 years of vaccination for nephrotic children and controls were 33.3±18 mg/L, 100.9±22.2 mg/L, 135.5±114.2 mg/L and 32.8±13 mg/L, 101.6±41.1 mg/L, 144.3± 64 mg/L, respectively. The increase in pneumococcal antibody levels in the 4th week (p<0.05) and the persistence of antibodies in the 3 year (p<0.05) were statistically significant and similar to the increases observed in the control group. 60% of the patients preserved their protective antibody levels at the 3rd year evaluation. None of the children showed neither side effects nor a pneumococcal infection episode during the study period.

Conclusion: We conclude that pneumococcal polysaccharide vaccine is a well tolerated and immunogenic vaccine in nephrotic children. Revaccination may be considered in nephrotic children after the assessment of antibody levels 3 years after vaccination.

Key words

Nephrotic syndrome, pneumococcal polysaccharide vaccine, child, vaccine efficiacy

Adv Mol Med 2007; 3(4): 177-181

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