Vaccine recommendations for children with idiopathic nephrotic syndrome

被引:2
|
作者
Boyer, Olivia [1 ]
Baudouin, Veronique [2 ]
Berard, Etienne [3 ]
Biebuyck-Gouge, Nathalie [1 ]
Dossier, Claire [2 ]
Guigonis, Vincent [4 ]
Audard, Vincent [5 ]
Klifa, Roman [1 ]
Leroy, Valerie [6 ]
Ranchin, Bruno [7 ]
Roussey, Gwenaelle [8 ]
Samaille, Charlotte [9 ]
Tellier, Stephanie [10 ]
Vrillon, Isabelle [11 ]
机构
[1] Univ Paris, Inst Imagine, Hop Necker Enfants Malad, Serv Nephrol Pediat,Ctr Reference Syndrome Nephro, 149 Rue Sevres, F-75015 Paris, France
[2] Univ Paris, Inst Imagine, Hop Robert Debre, Serv Nephrol Pediat,Ctr Reference Syndrome Nephro, 48 Blvd Serurier, F-75935 Paris 19, France
[3] CHU Nice, Serv Nephrol Pediat, Archet 2,151 Route St Antoine Ginestiere,CS 23079, F-06202 Nice 3, France
[4] Hop Mere Enfant, Dept Pediat, 8 Ave Dominique Larrey, F-87042 Limoges, France
[5] Univ Paris Est Creteil, CHU Henri Mondor, INSERM, U955,Serv Nephrol & Transplantat,Ctr Reference Sy, 51 Ave Marechal de Lattre de Tassigny, F-94010 Creteil, France
[6] CHU La Reunion, Serv Nephrol Pediat, Site Felix Guyon,Allee Topazes,CS 11021, F-97400 St Denis, Reunion, France
[7] CHU Lyon, Serv Nephrol Pediat, Ctr Reference Nephrogone, 59 Blvd Pinel, F-69500 Bron, France
[8] CHU Nantes, Clin Med Pediat, 5 Allee LIle Gloriette, F-44093 Nantes, France
[9] CHU Lille, Serv Nephrol Pediat, Hop Jeanne Flandre, Ave Eugene Avinee, F-59000 Lille, France
[10] Hop Enfants, Serv Nephrol Rhumatol Med Interne Pediat, Ctr Reference Malad Renales Rares Sud Ouest SORAR, 330 Ave Grande Bretagne, F-31300 Toulouse, France
[11] CHRU Nancy, Hop Enfants Brabois, Sect Nephrol Pediat, Serv Med Infantile, Rue Morvan, F-54500 Vandoeuvre Les Nancy, France
来源
NEPHROLOGIE & THERAPEUTIQUE | 2020年 / 16卷 / 03期
关键词
Corticosteroids; Immunosuppressants; Nephrotic syndrome; Relapse; Vaccines; Varicella; C CONJUGATE VACCINE; VARICELLA VACCINATION; CYCLOPHOSPHAMIDE; CHICKENPOX; RELAPSE; RISK;
D O I
10.1016/j.nephro.2019.09.007
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
The specific treatment of idiopathic nephrotic syndrome is based on corticosteroid therapy and/or steroid-sparing immunosuppressive agents in children who are steroid-dependant or frequent relapsers (60-70 %). Patients have an increased infectious risk not only related to the disease during relapses (hypogamma-globulinemia and urinary leakage of opsonins) but also to treatments (corticosteroids or immunosuppressive agents) in period of remission. Vaccination is therefore particularly recommended in these patients. Potential vaccine risks are ineffectiveness, induction of vaccine disease and relapse of idiopathic nephrotic syndrome. Only live vaccines expose to the risk of vaccine disease: they are in general contra-indicated under immunosuppressive treatment. The immunogenicity of inactivated vaccines is reduced but persists. The immunogenic stimulus of vaccination may in theory trigger a relapse of the nephrotic syndrome. Nevertheless, this risk is low in the literature, and even absent in some studies. The benefit-risk ratio is therefore in favor of vaccination with respect to the vaccination schedule for inactivated vaccines, with wide vaccination against pneumococcus and influenza annually. Depending on the context and after expert advice, immunization with live vaccines could be discussed if residual doses/levels of immunosuppressive treatments are moderate and immunity preserved. (C) 2020 Published by Elsevier Masson SAS on behalf of Societe francophone de nephrologie, dialyse et transplantation.
引用
收藏
页码:177 / 183
页数:7
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