Serum immunoglobulin E levels in children with idiopathic nephrotic syndrome
ABSTRACT: 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 association
with steroid-responsive nephrotic syndrome has not been fully elucidated.
Objective This study was done to investigate the association between
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/m2 body
surface area (BSA) for four weeks followed by a single dose of 40 mg/m2 BSA
every other day for another four weeks. This protocol was applied for
steroid-responsive INS children. Children with steroid resistance were given oral
cyclophosphamide 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 levels 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 nephrotic 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 serum IgE levels were significantly
higher in INS children with history of allergy, other factors that may
influence serum IgE levels must be considered.
Author: Ninik Asmaningsih, MD;
Windhu Poernomo, MD, MS, PhD; M Sjaifullah Noer, MD
Journal Code: jpkedokterangg050062
