Serum Immunoglobulin G and M as Predictors for Outcome of Childhood Nephrotic Syndrome

Abstract

Background: Nephrotic syndrome (NS) is characterised by a loss of albumin, proteins, and other plasma components  with comparable  bulk. Symptoms include decreasing serum albumin levels, increased blood lipid levels, lipids in urine,  and edema.

Objective: To estimate  serum levels of IgG, IgM, in nephrotic syndrome cases in addition to detect the  relationship between IgG/IgM ratio and response to  treatment with steroids.

Patients and Methods: The present study was carried out in Benha University Hospital, it comprised 60 children  admitted to Nephrology Unit of Pediatric Department of Benha University Hospitals. The cases were divided into four  groups: Group A  included 15 cases of frequent relapse N.S. (FRNS), Group B comprised 15 cases of steroid-resistant  nephrotic syndrome (SRNS), and  Group C consisted of 15 cases with infrequent relapses. Additionally, a control group  of 15 cases.

Results: In our study, serum IgM  showed a significant difference between the studied groups (P < 0.001). Pairwise  analysis revealed that it was significantly lower in the  control group (median = 0.71 mg/ml) than in groups A (median  = 1.48 mg/ml), B (median = 1.27 mg/ml), and C (median = 1.62 mg/ml).  ROC analyses were conducted to assess the  discriminatory potential of serum IgG and IgM levels among the different study groups  (Group A, Group B, and Group  C) compared to controls. For serum IgG, the analysis for all groups demonstrated significant AUC values,  ranging from  0.938 to 0.958, with confidence intervals indicating excellent discrimination. 

Conclusion: Our findings highlight the  potential of serum IgG and IgM levels as diagnostic markers for differentiating  nephrotic syndrome cases and provide valuable insights  into the pathophysiology and treatment response in these  patients.