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Year : 2015  |  Volume : 28  |  Issue : 2  |  Page : 431-436

Serum immunoglobulin G, M, and IgG : IgM ratio as predictors for outcome of childhood nephrotic syndrome

Pediatric Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Hassnaa Mahmoud Azab
Pediatric Department, Faculty of Medicine, Menoufia University, Al-Bajur, Al-Menoufia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-2098.163897

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Objectives The objectives of this study were to compare immunoglobulin (Ig) levels in children with nephrotic syndrome and healthy children to understand changes in diseased state and predict response to treatment. Background Nephrotic syndrome is an immune-mediated disorder of the kidney associated with T-cell dysfunction and secondary disturbance of B-cell with changes in levels of Ig and the IgG : IgM ratio. These changes in Ig levels can be used as a proxy marker to determine the clinical variety and prognosis of nephrotic syndrome. Materials and methods Twenty-five children with nephrotic syndrome attended the Nephrology Unit of Pediatric Department of Menoufia University Hospital from October 2011 to January 2013. Their ages ranged from 1 to 15 years (mean = 6.3 years); 12 (60%) were boys and eight (40%) were girls. All patients were in the active stage of the disease. Twenty-five apparently healthy children were enrolled as a control group. Results In the 25 children with nephrotic syndrome, 10 (40%) had steroid-sensitive nephrotic syndrome, five (20%) had steroid-resistant nephrotic syndrome, five (20%) developed frequent relapses, and five (20%) had infrequent relapse nephrotic syndrome. Compared with the healthy children, the IgG level was low, the IgM level was high, and the IgG : IgM ratio was low ( P ≤ 0.05). The serum IgG level and the IgG : IgM ratio were significantly lower in children with steroid-resistant nephrotic syndrome and in children with steroid-dependent nephrotic syndrome than in those with infrequent relapse nephrotic syndrome and in children with steroid-sensitive nephrotic syndrome ( P ≤ 0.05). Conclusion Management of different nephrotic syndromes is based on the levels of Ig along with clinical and biochemical parameters. The decrease in the IgG level as a predictive marker for an unfavorable prognosis of nephrotic syndrome in children needs further evaluation in larger scale studies.

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