Decline of vaccine-induced antipneumococcal antibody in children with nephrotic syndrome.
Twenty-five children with steroid-responsive idiopathic nephrotic syndrome were studied for persistence of antipneumococcal capsular polysaccharide antibody during relapse of their disease and at 1, 6, and 12 months after vaccination with the 14-valent pneumococcal vaccine. Nonrelapsers (group I) were compared to those who had at least one relapse but whose sera were obtained during remission (group II). Group II had a more rapid decline in total anticapsular antibody per month than group I (5.3% v 2.4%). Analysis by individual anticapsular types showed that differences between groups approached significance only for type 4 (P = .07). Rates of decline of antibody against pneumococcal capsular polysaccharide varied among types. One year after vaccination, 50% of patients had less than 300 ngAbN/mL against types 4, 6A, 7F, 8, and 19F. Sera obtained from seven patients during relapse had geometric mean antibody concentrations less than 300 ngAbN/mL against those same types; two of these types have been reported to cause disease in vaccinated patients with nephrosis. Decline of antibody against pneumococcal capsular polysaccharide following vaccination varies by capsular type. Type-specific analysis should be used when monitoring serum antibody levels in these patients after vaccination.
D000293:Adolescent; D000907:Antibodies, Bacterial / Q000032:analysis*; D001428:Bacterial Vaccines; D002648:Child; D002675:Child, Preschool; D005260:Female; D005921:Glomerulonephritis / Q000150:complications; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000209:etiology / Q000276:immunology*; D011008:Pneumococcal Infections / Q000276:immunology* / Q000517:prevention & control; D011507:Proteinuria / Q000209:etiology; D011863:Radioimmunoassay; D012008:Recurrence; D012306:Risk; D013296:Streptococcus pneumoniae / Q000276:immunology*; D013997:Time Factors; D014611:Vaccination
D000907:Antibodies, Bacterial; D001428:Bacterial Vaccines