MMR and the nephrotic syndrome.

Ahuja, Amisha; Wright, Morag

doi:10.1136/bmj.299.6702.796-a

Cited by 4 publications

(3 citation statements)

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“…Immunization resulted effective Measles-Rubella Kamei et al [ 21 ] Observational study (31) NS Live attenuated 0/0 Patients were receiving immunosuppression agents. Immunization resulted effective Ajay et al [ 23 ] Observational study (76) SSNS/FSGS Live attenuated NA SSNS were in active treatment with steroids and FSGS with ciclosporin/tacrolimus Measles-Mumps-Rubella Ahuja and Wright [ 24 ] Case report (1) Healthy Live attenuated 0/1 Steroid was effective in the treatment of NS, with no more relapse Varicella-zoster Alpay et al [ 26 ] Case series (20) SSNS Live attenuated 1/0 Relapse of NS in three weeks after vaccination Furth et al [ 27 ] Prospective multicenter clinical trial (29) SSNS Live attenuated 0/0 All patients developed adequate VZV antibody levels Kamei et al [ 21 ] Observational study (42) NS Live attenuated 2/0 Recurrences were reported at 16 and 22 day after vaccination N / A not available, NS nephrotic syndrome, SDNS steroid-dependent nephrotic syndrome, SSNS steroid-sensitive nephrotic syndrome, VZV: Varicella-zoster virus …”

Section: Resultsmentioning

confidence: 99%

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Vaccines and nephrotic syndrome: efficacy and safety

et al. 2022

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Vaccines represent the most important medical evolution in the last two centuries allowing prevention and formally eradication of a wide number of infectious diseases. Safety and effectiveness are main issues that still require an open discussion. A few clinical reports described a critical temporal relationship between vaccination and acute nephrotic syndrome, indirectly suggesting an association. For this review, the literature was reviewed to identify articles reporting associations of nephrotic syndrome with vaccines against a vast array of infectious diseases (including bacteria, virus and Sars-Cov-2). As specific aims, we evaluated effectiveness and safety in terms of occurrence of either “de novo” nephrotic syndrome in health subjects or “relapse” in those already affected by the disease. In total, 377 articles were found; 166 duplicates and 71 non-full text, animal studies or non-English language were removed. After excluding another 50 articles not containing relevant data on generic side effects or on relapses or new onset nephrotic syndrome, 90 articles met the search criteria. Overall, studies reported the effect of vaccines in 1015 patients, plus 4 nationwide epidemiologic investigations. Limited experience on vaccination of NS patients with measles, mumps, and rubella live attenuated vaccines does not allow any definitive conclusion on their safeness. VZV has been administered more frequently without side effects. Vaccines utilizing virus inactivated, recombinant, and toxoid can be utilized without risks in NS. Vaccines for influenza reduce the risk of infections during the pandemic and are associated with reduced risk of relapse of NS typically induced by the infection. Vaccines for SARS-CoV-2 (all kinds) offer a concrete approach to reduce the pandemic. “De novo” NS or recurrence are very rare and respond to common therapies.

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Section: Resultsmentioning

confidence: 99%

“…The unique case of NS following measles–mumps–rubella (MMR) has been reported in the literature in 1989. A 13-month-old girl developed “de novo” NS 6 days after vaccination and rapidly responded to steroids [ 24 ] (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Vaccines and nephrotic syndrome: efficacy and safety

et al. 2022

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“…However since relapses of SSNS are generally easily treated, achieving protection is usually deemed to be worth the risk. An increased relapse rate has been reported with HBV [23], and more rarely, with influenza, measles, and MMR vaccines [38,39]. On the contrary, measles infection has been reported as an agent which could induce a prolonged natural remission in some children with NS [40].…”

Section: Patients Receiving Steroidsmentioning

confidence: 99%

Vaccinations in children on immunosuppressive medications for renal disease

2015

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Renal diseases are often treated with immunosuppressive medications, placing patients at risk of infections, some of which are vaccine-preventable. However, in such patients vaccinations may be delayed or disregarded due to complications of the underlying disease process and challenges in its management. The decision to administer vaccines to immunosuppressed children is a risk-benefit balance as such children may have a qualitatively diminished immunological response or develop diseases caused by the vaccine pathogen. Vaccination may cause a flare-up of disease activity or provocation of graft rejection in renal transplant recipients. Moreover, it cannot be assumed that a given antibody level provides the same protection in immunosupressed children as in healthy ones. We have evaluated the safety and efficacy of licensed vaccines in children on immunosuppressive therapy and in renal transplant recipients. The limited evidence available suggests that vaccines are most effective if given early, ideally before the requirement for immunosuppressive therapy, which may require administration of accelerated vaccine courses. Once treatment with immunosuppressive drugs is started, inactivated vaccines are usually considered to be safe when the disease is quiescent, but supplemental doses may be required. In the majority of cases, live vaccines are to be avoided. All vaccines are generally contraindicated within 3-6 months of a renal transplant.

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Haemolytic uraemic syndrome following mumps, measles, and rubella vaccination

Karim

Masood

2002

Nephrology Dialysis Transplantation

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MMR and the nephrotic syndrome.

Cited by 4 publications

References 1 publication

Vaccines and nephrotic syndrome: efficacy and safety

Vaccines and nephrotic syndrome: efficacy and safety

Vaccinations in children on immunosuppressive medications for renal disease

Haemolytic uraemic syndrome following mumps, measles, and rubella vaccination

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