Abstract
Background: The commonest factor associated with frequent relapse in minimal change nephrotic syndrome is infection, either bacterial sepsis or viral infection. Among the viral infections, hepatitis B virus (HBV) has a prominent role. Steroid sensitive nephrotic syndrome (SSNS) patients are immunocompromised because of the disease itself as well its treatment with a steroid. Thus, their seroprotection will not be enough with conventional dose as that of a healthy person. Objective: To evaluate the seroresponse among SSNS with hepatitis B (HB) vaccination when they were in remission, to compare the antibody titre between single and double dose and to find out whether there were any complications following HB vaccination. Method: A prospective study was conducted among thirty SSNS children from July 2012 to June 2013; children were randomly assigned to be given either 10μg (Group-A) or 20μg (Group-B) of HBV vaccine. The vaccine was administered intramuscularly according to 0, 1, 2 months protocol. After one month of the last dose of vaccine, seroprotection rate was measured. Results: The mean vaccine titres of Group-A and Group-B were 25.60 ±19.97 mIU/ml and 617.47 ± 292.11 mIU/ml respectively. The mean vaccine titre difference between the 2 groups was statistically significant. Conclusion: Seroconversion was better observed by double dose (1ml) of HB vaccine in comparison to the single dose (0.5 ml) in children with SSNS during the remission period. There were no complications following HB vaccine during the study period.
Highlights
Nephrotic syndrome (NS) is characterized by massive proteinuria, hypoalbuminaemia, oedema and hyperlipidaemia[1]
The most common factor associated with frequent relapse in minimal change nephrotic syndrome (MCNS) is infection, either bacterial sepsis or viral infection
Thirty patients, having all the features of minimal change NS according to the International Study for Kidney Diseases for Children, and who were on oral prednisolone every other day and were hepatitis B surface antigen (HBsAg) negative were included in the study
Summary
Nephrotic syndrome (NS) is characterized by massive proteinuria, hypoalbuminaemia, oedema and hyperlipidaemia[1]. In comparison to developed countries, steroid sensitive NS (SSNS) patients in Bangladesh are more immunocompromised. Their immune response is lower due to the disease process, steroid overuse and chronic malnutrition. The commonest factor associated with frequent relapse in minimal change nephrotic syndrome is infection, either bacterial sepsis or viral infection. Steroid sensitive nephrotic syndrome (SSNS) patients are immunocompromised because of the disease itself as well its treatment with a steroid. Their seroprotection will not be enough with conventional dose as that of a healthy person
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