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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Estudiar la inmunogenicidad de la vacuna antineumoc&#243;cica de 23 polisac&#225;ridos en ni&#241;os con diversos tipos de enfermedad renal cr&#243;nica y en los afectados de s&#237;ndrome nefr&#243;tico&#44; y compararla con la obtenida en ni&#241;os sanos&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se han incluido en el estudio 150 ni&#241;os mayores de 2 a&#241;os&#58; 113 con enfermedad renal &#40;26 con s&#237;ndrome nefr&#243;tico&#44; 23 con reflujo vesicoureteral grado III-IV&#44; 16 con insuficiencia renal cr&#243;nica&#44; 6 con trasplante renal&#44; 6 en hemodi&#225;lisis y 36 con otras enfermedades renales&#41; &#40;grupo 1&#41; y 37 sanos &#40;grupo 2&#41;&#44; a los que se administr&#243; una dosis de vacuna&#46; Se ha determinado la concentraci&#243;n de IgG total espec&#237;fica frente a neumococo antes de la vacunaci&#243;n y a los 30 d&#237;as de la misma por el m&#233;todo ELISA&#46; Se comparan los resultados obtenidos entre los dos grupos de ni&#241;os&#44; as&#237; como la respuesta observada entre el subgrupo de ni&#241;os con enfermedades renales en las que la vacuna est&#225; indicada &#40;s&#237;ndrome nefr&#243;tico&#44; insuficiencia renal cr&#243;nica&#44; trasplante renal y terapia con hemodi&#225;lisis&#41; &#40;grupo 3&#41; y los ni&#241;os sanos&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El 87&#44;3&#37; de los ni&#241;os duplicaron las concentraciones de anticuerpos al mes de la vacunaci&#243;n&#44; no observ&#225;ndose diferencias significativas entre los tres grupos&#46; Se consider&#243; que la vacuna fue inmun&#243;gena en el 78&#44;4&#37; de los ni&#241;os sanos&#44; en el 77&#44;9&#37; de los del grupo 1 y en el 72&#44;5&#37; de los del grupo 3 &#40;p &#61; 0&#44;533&#41;&#46; Los ni&#241;os con trasplante renal y los sometidos a hemodi&#225;lisis presentaron una respuest amenor&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La vacuna antineumoc&#243;cica de 23 polisac&#225;ridos es inmun&#243;gena en ni&#241;os mayores de 2 a&#241;os con insuficiencia renal cr&#243;nica&#44; s&#237;ndrome nefr&#243;tico&#44; sometidos a trasplante renal o a hemodi&#225;lisis&#46; Hay que destacar la importancia de aumentar la cobertura vacunal en este grupo de enfermos de alto riesgo de enfermedad neumoc&#243;cica invasiva&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To study the immunogenicity of the 23-valent pneumoccal vaccine in children with chronic renal diseaseand in those with nephrotic syndrome&#44; and to compare it with the response in healthy children&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The vaccine was administered to 150 children aged 2-18 years&#58; 113 with renal diseases &#40;26 with nephrotic syndrome&#44; 23 with severe grades of vesicoureteral reflux&#44; 16with chronic renal insufficiency&#44; 6 renal transplant recipients&#44; 6 requiring dialysis and 36 with other renal diseases&#41; &#40;group 1&#41; and 37 healthy &#40;group 2&#41;&#46; Specific IgG antibodies concentrations were measured by ELISA before and 30 days after vaccination&#46; The results obtained in both groups were compared&#46; We compared too the response observed between the subgroup of children with renal diseases in which pneumococcal vaccine is indicated &#40;nephrotic syndrome&#44; chronic renal insufficiency&#44; renal transplant and those requiring dialysis &#40;group 3&#41; and healthy children&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">87&#46;3&#37; of children showed a 2-fold increase in antibody concentrations after vaccination&#46; No significant differences were observed between the three groups&#46; We considered that the vaccine was immunogenic in 78&#46;4&#37; of healthy children&#44; in 77&#46;9&#37; of group 1 children and in 72&#46;5&#37; of those in the group 3 &#40;p &#61; 0&#44;533&#41;&#46; A lower responsewas observed in children with a kidney transplant and in those requiring dialysis&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">These results suggest that 23-valent pneumococcal vaccine is immunogenic in children with chronic renal diseases or nephrotic syndrome and may protect these patients from invasive pneumococcal disease&#46; The importance of improved vaccine coverage is emphasized&#46;</p>"
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Vol. 52. Núm. 3.
Páginas 220-224 (marzo 2000)
Acceso a texto completo
Inmunogenicidad de la vacuna antineumocócica de 23 polisacáridos en niños con enfermedad renal crónica
Immunogenicity of the 23-valent pneumococcal vaccine in children with chronic renal disease
Visitas
10342
M.J. Rodrigo Anoroa, L. Callís Braconsb, M.J. Cruz Carmonaa, J. de Gracia Roldánc, M. Miravitlles Fernándezc
a Laboratorio de Bioquímica. Hospitals Vall d'Hebron
c Servicio de Neumología. Hospitals Vall d'Hebron
b Servicio de Nefrología Pediátrica. Hospital Materno-infantil Vall d‘Hebron. Universitat Autònoma de Barcelona
M. Campins Martí, N. Pinart Pons
Servicio de Medicina Preventiva
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Estadísticas
Objetivos

Estudiar la inmunogenicidad de la vacuna antineumocócica de 23 polisacáridos en niños con diversos tipos de enfermedad renal crónica y en los afectados de síndrome nefrótico, y compararla con la obtenida en niños sanos.

Métodos

Se han incluido en el estudio 150 niños mayores de 2 años: 113 con enfermedad renal (26 con síndrome nefrótico, 23 con reflujo vesicoureteral grado III-IV, 16 con insuficiencia renal crónica, 6 con trasplante renal, 6 en hemodiálisis y 36 con otras enfermedades renales) (grupo 1) y 37 sanos (grupo 2), a los que se administró una dosis de vacuna. Se ha determinado la concentración de IgG total específica frente a neumococo antes de la vacunación y a los 30 días de la misma por el método ELISA. Se comparan los resultados obtenidos entre los dos grupos de niños, así como la respuesta observada entre el subgrupo de niños con enfermedades renales en las que la vacuna está indicada (síndrome nefrótico, insuficiencia renal crónica, trasplante renal y terapia con hemodiálisis) (grupo 3) y los niños sanos.

Resultados

El 87,3% de los niños duplicaron las concentraciones de anticuerpos al mes de la vacunación, no observándose diferencias significativas entre los tres grupos. Se consideró que la vacuna fue inmunógena en el 78,4% de los niños sanos, en el 77,9% de los del grupo 1 y en el 72,5% de los del grupo 3 (p = 0,533). Los niños con trasplante renal y los sometidos a hemodiálisis presentaron una respuest amenor.

Conclusiones

La vacuna antineumocócica de 23 polisacáridos es inmunógena en niños mayores de 2 años con insuficiencia renal crónica, síndrome nefrótico, sometidos a trasplante renal o a hemodiálisis. Hay que destacar la importancia de aumentar la cobertura vacunal en este grupo de enfermos de alto riesgo de enfermedad neumocócica invasiva.

Palabras clave:
Enfermedad neumocócica
Vacuna antineumocócica de 23 polisacáridos
Insuficiencia renal crónica
Síndrome nefrótico
Niños
Objective

To study the immunogenicity of the 23-valent pneumoccal vaccine in children with chronic renal diseaseand in those with nephrotic syndrome, and to compare it with the response in healthy children.

Methods

The vaccine was administered to 150 children aged 2-18 years: 113 with renal diseases (26 with nephrotic syndrome, 23 with severe grades of vesicoureteral reflux, 16with chronic renal insufficiency, 6 renal transplant recipients, 6 requiring dialysis and 36 with other renal diseases) (group 1) and 37 healthy (group 2). Specific IgG antibodies concentrations were measured by ELISA before and 30 days after vaccination. The results obtained in both groups were compared. We compared too the response observed between the subgroup of children with renal diseases in which pneumococcal vaccine is indicated (nephrotic syndrome, chronic renal insufficiency, renal transplant and those requiring dialysis (group 3) and healthy children.

Results

87.3% of children showed a 2-fold increase in antibody concentrations after vaccination. No significant differences were observed between the three groups. We considered that the vaccine was immunogenic in 78.4% of healthy children, in 77.9% of group 1 children and in 72.5% of those in the group 3 (p = 0,533). A lower responsewas observed in children with a kidney transplant and in those requiring dialysis.

Conclusions

These results suggest that 23-valent pneumococcal vaccine is immunogenic in children with chronic renal diseases or nephrotic syndrome and may protect these patients from invasive pneumococcal disease. The importance of improved vaccine coverage is emphasized.

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