Phenotypes of B-Lymphocytes as a Predictor of Steroid Response in Idiopathic Nephrotic Syndrome.

Arab, Faika; Youssef, Doaa; Ibrahim, Fatma Alzahraa G.; El-korashi, Lobna A.; Fathey, Hoda

doi:10.21608/geget.2021.49509.1016

Phenotypes of B-Lymphocytes as a Predictor of Steroid Response in Idiopathic Nephrotic Syndrome.

Document Type : Original Article

Authors

¹ Department of Pediatrics, Pediatric Nephrology Unit, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

² Department of Medical Microbiology & Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

³ Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

10.21608/geget.2021.49509.1016

Abstract

Introduction: The pathogenesis of Idiopathic nephrotic syndrome (INS) is not clear, where the role of B-cells is not yet illustrated.
Aim of the study: To evaluate B- cells subsets as a predictor of steroid therapy sensitivity among INS at initial onset.
Methods: 45 children with idiopathic nephrotic syndrome were recruited in a follow- up study, patients were divided into steroid-sensitive nephrotic syndrome (SSNS) and steroid-resistant nephrotic syndrome (SRNS) groups based on their sensitivities to steroids. Venous blood samples were drawn from all children for assessment of memory B- cell population before and after one year of steroid therapy.
Results: We found statistically significant relation between steroid response and total memory CD19+ CD27+B cell at disease onset where it was higher in SSNS group. Our results showed The best cut-off of total CD19+ B cells in predicting steroid response was ≥32.7 with an area under curve (AUC) of 0.445, a sensitivity of 43.9%, a specificity of 50%, a positive predictive value (PPV) of 90%, a negative predictive value (NPV) of 8% and an accuracy of 44.4% (p>0.05) We also found that The best cut-off of CD19+ CD 27+ total memory B cells in predicting steroid response was ≥32 with an AUC of 0.817, a sensitivity of 78%, a specificity of 75%, a PPV of 97%, a NPV of 25% and an accuracy of 77.8% (p < 0.05).
Conclusion: CD19+ CD 27+ total memory B cells could help in predicting steroid response among INS patients with a cut-off of total CD 19+B cells above 32.7 and PPV of 90% , a cut-off above 32 in CD19+ CD +27 total memory cells and PPV 97%.

Keywords