Risk Factors for Infection and Immunoglobulin Replacement Therapy in Adult Nephrotic Syndrome

Ogi, Makoto; Yokoyama, Hitoshi; Tomosugi, Naohisa; Hisada, Yukimasa; Ohta, Satoshi; Takaeda, Masayoshi; Wada, Takashi; Naito, Tateaki; Ikeda, Kenzo; Goshima, Satoshi; Takasawa, Kazuya; Kobayashi, Kenichi

doi:10.1016/s0272-6386(12)80899-7

Cited by 80 publications

(43 citation statements)

References 20 publications

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“…Patient 9 had received intravenous immunoglobulin (IVIG) treatment. Administration of IVIG may reduce the risk of infection in adult NS patients with serum IgG levels below 600 mg/dl [18]. In children, IVIG infusions provide only hours of adequate IgG concentrations due to rapid urinary losses in congenital NS [19].…”

Section: Discussionmentioning

confidence: 99%

Microbiological spectrum of septicemia and peritonitis in nephrotic children

Tain

Lin

Cher

1999

Pediatric Nephrology

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From April 1993 to December 1997, 452 admissions of 231 children with nephrotic syndrome to Chang Gung Children's Hospital were retrospectively reviewed. There were 10 episodes of sepsis and 8 episodes of peritonitis in 18 children, and 14 microorganisms were cultured. Two children died due to Streptococcus pneumoniae sepsis. Gram-positive microorganisms (n=7) and Gram-negative microorganisms (n=7) were found in equal numbers. Enterococcus (1), Streptococcus pneumoniae (4), group D streptococcus (1), and Streptococcus viridans (1) were the Gram-positive microorganisms cultured. Two of 4 cases of Streptococcus pneumoniae sepsis were penicillin resistant. Gram-negative microorganisms included Enterobacter cloacae (1), Klebsiella pneumoniae (1), Escherichia coli (2), Acinetobacter baumannii (1), Neisseria meningitidis (1), and group B salmonella (1). The last three microorganisms have not been previously associated with nephrotic children. Vancomycin therapy to cover penicillin-resistant Streptococcus pneumoniae and a third-generation cephalosporin therapy to cover rare Gram-negative microorganisms should be considered in serious infections of nephrotic children.

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Section: Discussionmentioning

confidence: 99%

Microbiological spectrum of septicemia and peritonitis in nephrotic children

Tain

Lin

Cher

1999

Pediatric Nephrology

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“…Patients have an increased susceptibility to infection because of low serum IgG concentrations, reduced complement activity, and depression of T-cell function. 8 Together with the use of corticosteroids and other immunosuppressive agents, all these factors increase the risk for infection in nephrotic patients. With respect to the spectrum of infections, a variety of infectious complications have been reported in patients with nephrotic syndrome, particularly bacterial infections.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing Fasciitis Caused bySerratia marcescens: A Fatal Complication of Nephrotic Syndrome

Wen

2012

Renal Failure

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Necrotizing fasciitis is an uncommon complication of nephrotic syndrome. There have been only four cases of necrotizing fasciitis complicating nephrotic syndrome reported in the English literature. We report a 40-year-old woman with minimalchange nephrotic syndrome receiving cyclosporine therapy, who suffered from necrotizing fasciitis of her left leg. Cultures of blood and surgical specimens yielded Serratia marcescens. Despite aggressive treatment, the patient expired shortly after surgery. We review the literature and find eight cases of necrotizing fasciitis caused by S. marcescens. Most of these patients had an immunocompromised background, and the mortality rate was high.

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“…15 These diseases are distinguished from primary humoral immunodeficiency by the presence of oedema and decreased serum albumin. Treatment with immunosuppressive drugs, such as glucocorticoids, further increases the risk of infection.…”

Section: Immunoglobulin Lossmentioning

confidence: 99%

Secondary antibody deficiency – causes and approach to diagnosis

Srivastava

Wood

2016

Clinical Medicine

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AAntibody defi ciencies can occur in the context of primary disorders due to inherited genetic defects; however, secondary immune disorders are far more prevalent and can be caused by various diseases and their treatment, certain medications and surgical procedures. Immunoglobulin replacement therapy has been shown to be effective in reducing infections, morbidity and mortality in primary antibody defi ciencies but secondary antibody defi ciencies are in general poorly defi ned and there are no guidelines for the management of patients with this condition. Clinical decisions are based on experience from primary antibody defi ciencies. Both primary and secondary antibody defi ciencies can be associated with infections, immune dysregulation and end-organ damage, causing signifi cant morbidity and mortality. Therefore, it is important to diagnose and treat these patients promptly to minimise adverse effects and improve quality of life. We focus on secondary antibody defi ciency and describe the causes, diagnosis and treatment of this disorder.

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Risk Factors for Infection and Immunoglobulin Replacement Therapy in Adult Nephrotic Syndrome

Cited by 80 publications

References 20 publications

Microbiological spectrum of septicemia and peritonitis in nephrotic children

Microbiological spectrum of septicemia and peritonitis in nephrotic children

Necrotizing Fasciitis Caused bySerratia marcescens: A Fatal Complication of Nephrotic Syndrome

Secondary antibody deficiency – causes and approach to diagnosis

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