Serum immunoglobulin E levels in children with idiopathic nephrotic syndrome

Background Children with idiopathic nephrotic syndrome (INS) have been known to have T-cell dysfunction and an impairment of the cytokine network that may alter glomerular permeability and the glomerular filtration barrier. This disorder may contribute to the presence of urinary protein loss in children with INS. The elevation of serum IgE levels has been noted in some cases, but its association with steroid-responsive nephrotic syndrome has not been fully elucidated. Objective This study was done to investigate the association between serum IgE levels prior to prednisone treatment in children with INS and the outcome of treatment. Methods A prospective observational study has been conducted on 22 children with INS. Prednisone therapy was given with a dose of 60 mg/m2 body surface area (BSA) for four weeks followed by a single dose of 40 mg/m2 BSA every other day for another four weeks. This protocol was applied for steroid-responsive INS children. Children with steroid resistance were given oral cyclophosphamide 2 mg/kg for eight weeks. IgE level measurements were performed prior to prednisone therapy and at remission. Data were analyzed using one-way ANOVA and multiple regression. Results Twenty-two children were enrolled in this study. High levels of serum IgE were found in 95.5% of children, with a mean of 2002.5 (SD 2172.1) IU/ml. The serum IgE levels of INS children with history of allergy were significantly higher than those of nephrotic children without history of allergy (P< 0.05). However, there was no significant correlation between the serum IgE levels and the outcome of treatment in children with INS. Conclusion The high serum IgE levels in children with INS seem to be associated with humoral immune disorder and did not have any association with the outcome of therapy. Even though the serum IgE levels were significantly higher in INS children with history of allergy, other factors that may influence serum IgE levels must be considered.