Khalid Alfakeekh1, Mohammed Azar2, Banan Al Sowailmi3, Saja Alsulaiman4, Salwa Al Makdob5, Aamir Omair6, Esam Albanyan7, Manal Saleh Bawazeer8. 1. Department of Paediatrics, Division of Nephrology, Ministry of National Guard, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, King Abdullah Specialized Children Hospital, Mail Code 1940, P. O. Box 22490, Riyadh,11426, Saudi Arabia. Electronic address: fakeehk@ngha.med.sa. 2. Department of Paediatrics, Division of Nephrology, Ministry of National Guard, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, King Abdullah Specialized Children Hospital, Mail Code 1940, P. O. Box 22490, Riyadh,11426, Saudi Arabia. Electronic address: shameemazar@gmail.com. 3. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Electronic address: banan.alsowailmi@gmail.com. 4. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Electronic address: Saja.alsulaiman@hotmail.com. 5. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Electronic address: Salwa.abdulfattah@gmail.com. 6. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Electronic address: omaira@ksau-hs.edu.sa. 7. Department of Paediatrics, Division of Nephrology, Ministry of National Guard, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, King Abdullah Specialized Children Hospital, Mail Code 1940, P. O. Box 22490, Riyadh,11426, Saudi Arabia. Electronic address: ealbanyan@hotmail.com. 8. Department of Paediatrics, Division of Nephrology, Ministry of National Guard, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, King Abdullah Specialized Children Hospital, Mail Code 1940, P. O. Box 22490, Riyadh,11426, Saudi Arabia. Electronic address: bawazeerm@ngha.med.sa.
Abstract
INTRODUCTION: Patients with primary childhood nephrotic syndrome (PCNS) develop alterations in their cellular and humoral immunity that predisposes them to the development of infection, and lead them to have frequent relapses. Also, infection could be significantly enhanced by immunosuppressive agents. This study aims to estimate the immunosuppressive burden, rate of infection and identify possible risk factors in PCNS requiring hospitalization. METHODOLOGY: A cross-sectional study of hospitalized children≤14years of age diagnosed with PCNS in King Abdul-Aziz Medical City, Riyadh from January 2003 to December 2013. RESULT: Out of 111 patients admitted with PCNS, 84 (76%) had both minor and major types of infection. Upper respiratory tract infection (URTI) was the most predominant type (n=44, 52%). Among the major types of infection, urinary tract infection (UTI) was the most common infection (n=21, 25%) followed by pneumonia (n=17, 20%) then cellulitis (n=6, 6%). Infection in children who received a higher annual cumulative dose of steroids (CDS) strikingly had a higher rate of infection in comparison to those who received lower CDS (p<0.01). Moreover, those who received primary and secondary immunosuppressant's had 100% infection rate. CONCLUSION: About half of infection encountered by PCNS patients were URTI followed by UTI and pneumonia. Higher annual CDS, combination of primary and secondary immunosuppressants were the highest independent risk factors for infection. Among the infection, URTI was considered as the predominant entity whereas among the major infection, UTI was predominant followed by pneumonia then cellulitis.
INTRODUCTION:Patients with primary childhood nephrotic syndrome (PCNS) develop alterations in their cellular and humoral immunity that predisposes them to the development of infection, and lead them to have frequent relapses. Also, infection could be significantly enhanced by immunosuppressive agents. This study aims to estimate the immunosuppressive burden, rate of infection and identify possible risk factors in PCNS requiring hospitalization. METHODOLOGY: A cross-sectional study of hospitalized children≤14years of age diagnosed with PCNS in King Abdul-Aziz Medical City, Riyadh from January 2003 to December 2013. RESULT: Out of 111 patients admitted with PCNS, 84 (76%) had both minor and major types of infection. Upper respiratory tract infection (URTI) was the most predominant type (n=44, 52%). Among the major types of infection, urinary tract infection (UTI) was the most common infection (n=21, 25%) followed by pneumonia (n=17, 20%) then cellulitis (n=6, 6%). Infection in children who received a higher annual cumulative dose of steroids (CDS) strikingly had a higher rate of infection in comparison to those who received lower CDS (p<0.01). Moreover, those who received primary and secondary immunosuppressant's had 100% infection rate. CONCLUSION: About half of infection encountered by PCNSpatients were URTI followed by UTI and pneumonia. Higher annual CDS, combination of primary and secondary immunosuppressants were the highest independent risk factors for infection. Among the infection, URTI was considered as the predominant entity whereas among the major infection, UTI was predominant followed by pneumonia then cellulitis.
Authors: Dorey A Glenn; Candace D Henderson; Michelle O'Shaughnessy; Yichun Hu; Andrew Bomback; Keisha Gibson; Larry A Greenbaum; Jarcy Zee; Laura Mariani; Ronald Falk; Susan Hogan; Amy Mottl Journal: Clin J Am Soc Nephrol Date: 2020-10-20 Impact factor: 8.237
Authors: Hengci Zhang; Shiyuan Qiu; Cheng Zhong; Lin Shi; Jiacheng Li; Tao Zhang; Xiaoping Zhu; Mo Wang Journal: Front Pediatr Date: 2021-07-14 Impact factor: 3.418