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Review
. 2019 Aug 13:7:339.
doi: 10.3389/fped.2019.00339. eCollection 2019.

Safety and Efficacy of Pneumococcal Vaccination in Pediatric Nephrotic Syndrome

Shamitha Thishakya Goonewardene  1   2   3 , Calyn Tang  1   2   3 , Loh Teng-Hern Tan  2   4 , Kok-Gan Chan  5   6 , Prithvy Lingham  1 , Learn-Han Lee  2   7 , Bey-Hing Goh  3   7 , Priyia Pusparajah  1   7
Affiliations
Review

Safety and Efficacy of Pneumococcal Vaccination in Pediatric Nephrotic Syndrome

Shamitha Thishakya Goonewardene et al. Front Pediatr. .

Abstract

Nephrotic syndrome affects both children and adults. Idiopathic nephrotic syndrome is reported to be one of the most frequent renal pathologies in childhood. Nephrotic children are at high risk for severe pneumococcal infections as one of the life-threatening complications of nephrotic syndrome due to involvement of the immunosuppressive regimen and the acquired immune deficiency induced by nephrotic syndrome including decreased plasma IgG and low complement system components. Aiming to prevent pneumococcal infection is of paramount importance especially in this era of ever-increasing pneumococcal resistance to penicillins and cephalosporins. The pneumococcal vaccines currently available are inactivated vaccines-the two main forms in use are polysaccharide vaccines and conjugated vaccines. However, the data supporting the use of these vaccines and to guide the timing and dosage recommendations is still limited for nephrotic children. Thus, this review discusses the evidences of immunogenicity and safety profile of both vaccinations on nephrotic patients as well as the effect of nephrotic syndrome treatment on vaccine seroresponses.

Keywords: efficacy; nephrotic; pediatric; pneumococcal; vaccination.

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Figures

Figure 1
Figure 1
Predisposing factors to pneumococcal infection in Nephrotic Syndrome and pneumococcal vaccination as a strategy to reduce the risk of pneumococcal infection.
Figure 2
Figure 2
Complement cascade for classical and alternative pathways illustrating the deficiencies in the complement system in Nephrotic Syndrome.
Figure 3
Figure 3
Mechanisms of immunogenicity of PPV vs. PCV.
Figure 4
Figure 4
Recommended pneumococcal immunization pathway for children with Nephrotic Syndrome.
See this image and copyright information in PMC

References

    1. Cadnapaphornchai MA, Tkachenko O, Shchekochikhin D, Schrier RW. The nephrotic syndrome: pathogenesis and treatment of edema formation and secondary complications. Pediatr Nephrol. (2014) 29:1159–67. 10.1007/s00467-013-2567-8 - DOI - PubMed
    1. Metz DK, Kausman JY. Childhood nephrotic syndrome in the 21st century: what's new? J Paediatr Child Health. (2015) 51:497–504. 10.1111/jpc.12734 - DOI - PubMed
    1. Eddy AA, Symons JM. Nephrotic syndrome in childhood. Lancet. (2003) 362:629–39. 10.1016/S0140-6736(03)14184-0 - DOI - PubMed
    1. Andolino TP, Reid-Adam J. Nephrotic syndrome. Pediatr Rev. (2015) 36:117–26. 10.1542/pir.36-3-117 - DOI - PubMed
    1. Andersen RF, Thrane N, Noergaard K, Rytter L, Jespersen B, Rittig S. Early age at debut is a predictor of steroid-dependent and frequent relapsing nephrotic syndrome. Pediatr Nephrol. (2010) 25:1299–304. 10.1007/s00467-010-1537-7 - DOI - PubMed

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