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Seroprotection against measles in previously vaccinated children with difficult-to-treat nephrotic syndrome

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Abstract

Background

Children with nephrotic syndrome (NS) are vulnerable to infections. Measles infection is an important cause of morbidity and mortality in immunosuppressed children. A suboptimal seroprotection against measles has been shown in immunocompromised children. There is limited published literature on measles immunity in children with difficult-to-treat nephrotic syndrome (DTNS). We compared the proportions of children with DTNS and healthy controls who were seroprotected against measles.

Methods

This was a cross-sectional study. Measles-specific IgG antibodies of 108 children with DTNS (3 to 10 years of age) and an equal number of age-matched healthy controls were measured. All children had received two doses of measles-containing vaccine at 9–12 and 16–24 months of age under routine immunisation programme. Serum measles IgG antibody titres were measured by indirect ELISA. The assay results were interpreted as (1) > 11 NTU (NovaTec Units), positive/seroprotective titres; (2) 9–11, equivocal; and (3) < 9 NTU, negative. Inter- and intra-group comparisons were made to identify the disease characteristics related to seroprotection status.

Results

The proportion of children with protective anti-measles antibodies (n = 70, 65%) was significantly lower in DTNS as compared to controls (n = 88, 81.48%) (p = 0.005). Their median [IQR] antibody titres were also significantly lower than those in controls (14.1 [14] NTU vs. 18.3 [15.2] NTU (p = 0.001). The age, gender, clinical subtype, duration of disease, and type of immunosuppressive therapy were not significantly different between seroprotected and non-seroprotected children with DTNS.

Conclusion

A significantly lower percentage of fully vaccinated children with DTNS were seroprotected against measles compared to healthy controls.

Graphical abstract

A higher resolution version of the Graphical abstract is available as Supplementary information.

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Data availability

Data will be made available upon request.

Code availability

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Change history

  • 12 December 2021

    ESM was extended to include the article's Graphical abstract.

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Acknowledgements

The authors wish to thank the study participants and their parents, and the resident doctors, nurses and technicians from the Departments of Pediatrics and Microbiology.

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Authors and Affiliations

  1. Department of Pediatrics, Kalawati Saran Children’s Hospital & Lady Hardinge Medical College, Bangla Sahib Road, New Delhi, 110001, India

    Jiten Kumar Sahoo, Soumya Tiwari & Viswas Chhapola

  2. Department of Microbiology, Lady Hardinge Medical College, Bangla Sahib Road, New Delhi, 110001, India

    Manoj Jais

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  1. Jiten Kumar Sahoo
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  2. Soumya Tiwari
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  4. Manoj Jais
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Contributions

ST, VC, MJ, and JKS were involved in the study design and data acquisition. ST and VC were involved in data analysis and interpretation. ST, VC, MJ, and JKS drafted the manuscript, performed critical revisions, and gave final approval for submission.

Corresponding author

Correspondence to Soumya Tiwari.

Ethics declarations

Ethics approval

The study was approved by the Institutional Ethics Committee (LHMC/ECHR/2018/791), and conducted in accordance with Good Clinical Practice and the Declaration of Helsinki.

Consent to participate

Written informed consent was obtained from the parents or legal guardians of all children. When possible, consent from the patients themselves was also obtained.

Consent for publication

Study participants gave written informed consent for publication of the results of the study before their enrolment in the study.

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The authors declare no competing interests.

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Sahoo, J.K., Tiwari, S., Chhapola, V. et al. Seroprotection against measles in previously vaccinated children with difficult-to-treat nephrotic syndrome. Pediatr Nephrol 37, 843–848 (2022). https://doi.org/10.1007/s00467-021-05290-7

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  • DOI: https://doi.org/10.1007/s00467-021-05290-7

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