Serological Markers of Viral, Syphilitic and Toxoplasmic Infection in Children and Teenagers With Nephrotic Syndrome: Case Series From Mato Grosso State, Brazil

Abstract

Some infections can be the cause of secondary nephrotic syndrome. The aim of this study was to describe the experience of a Renal Disease Reference Clinic from Central Brazil, in which serological markers of some infectious agents are systematically screened in children with nephrotic syndrome. Data were obtained from the assessment of medical files of all children under fifteen years of age, who matched nephrotic syndrome criteria. Subjects were tested for IgG and IgM antibodies against T. gondii and cytomegalovirus; antibodies against Herpes simplex, hepatitis C virus and HIV; and surface antigen (HBsAg) of hepatitis B virus. The VDRL test was also performed. 169 cases were studied. The median age on the first visit was 44 months and 103 (60.9%) patients were male. Anti-CMV IgG and IgM were found in 70.4% and 4.1%, respectively. IgG and IgM against Toxoplasma gondii were present in 32.5% and 5.3%, respectively. Two patients were positive for HBsAg, but none showed markers for HIV, hepatitis C, or Treponema pallidum. IgG and IgM against herpes simplex virus were performed on 54 patients, of which 48.1% and 22.2% were positive. IgM antibodies in some children with clinical signs of recent infection suggest that these diseases may play a role in the genesis of nephrotic syndrome.

Frequency of cytomegalovirus infection in children with Nephrotic Syndrome

“…In our study there were non-signi icant differences between IgM positive-patients vs IgM-negative patients regarding age, sex and irst attack or relapsed NS patients (p>0.05); this is in agreement with [11], in their study they found. (3 cases relapsed from the 7 nephrotic children cases with cmv IgM + ve ) and 103 (60.9%) out of the 169 nephrotic children were male but disagree regarding to age as they found the median age on the irst visit was 44 months.…”

“…Here, we investigate the link between CMV infect ion and NS in children. In our study we found that 7 (12%) of nephrotic syndrome children cases were CMV IgM +ve, 53 (88%) were CMV IgM -ve and all 60 screened children were CMV IgG +ve (100%), This is in agreement with [11], who investigated Serological markers of viral, syphilitic and toxoplasmic infection in children and teenagers with nephrotic syndrome.…”

Rate and Type of Infections in Children with Nephrotic Syndrome

“…According to Soares et al [9] There was a significant decrease in the incidence and transmission of infection nowadays in Brazil because of the wider vaccination administration to children. This may explain less incidence of this infection as a cause of NS; While Alwadhi et al [5] reported that of the 76 activities, 8 were excluded from analysis.…”

“…While not all cases receiving azathioprine presented with active disease .that means that cyclosporine precipitate infection. According to Soares et al [9] immunosuppressant in children with chronic infections may lead to the deterioration of the infection and of the general clinical state. So; most regimes of management of children with NS suggest screening of infections, because these may need specific treatment.…”

Nephrotic syndrome secondary to cytomegalovirus infection in an infant. Case report

“…Według brazylijskich badaczy u 4,1% dzieci z zespołem nerczycowym stwierdza się wykładniki świeżej infekcji wirusem cytomegalii (IgM). Autorzy twierdzą, że obecność przeciwciał w klasie IgM u dzieci z objawami niedawno przebytej infekcji układu oddechowego mogą wskazywać na związek CMV z rozwojem zespołu nerczycowego (2) . Według Dossier i wsp.…”