Phenotypes of B-Lymphocytes as a Predictor of Steroid Response in Idiopathic Nephrotic Syndrome.
Arab, F., Youssef, D., Ibrahim, F., El-korashi, L., Fathey, H. (2020). Phenotypes of B-Lymphocytes as a Predictor of Steroid Response in Idiopathic Nephrotic Syndrome.. EKB Journal Management System, 15(2), 28-35. doi: 10.21608/geget.2021.49509.1016
Faika Arab; Doaa Youssef; Fatma Alzahraa G. Ibrahim; Lobna A. El-korashi; Hoda Fathey. "Phenotypes of B-Lymphocytes as a Predictor of Steroid Response in Idiopathic Nephrotic Syndrome.". EKB Journal Management System, 15, 2, 2020, 28-35. doi: 10.21608/geget.2021.49509.1016
Arab, F., Youssef, D., Ibrahim, F., El-korashi, L., Fathey, H. (2020). 'Phenotypes of B-Lymphocytes as a Predictor of Steroid Response in Idiopathic Nephrotic Syndrome.', EKB Journal Management System, 15(2), pp. 28-35. doi: 10.21608/geget.2021.49509.1016
Arab, F., Youssef, D., Ibrahim, F., El-korashi, L., Fathey, H. Phenotypes of B-Lymphocytes as a Predictor of Steroid Response in Idiopathic Nephrotic Syndrome.. EKB Journal Management System, 2020; 15(2): 28-35. doi: 10.21608/geget.2021.49509.1016

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

GEGET
Article 3, Volume 15, Issue 2, December 2020, Page 28-35  XML PDF (287.06 K)
Document Type: Original Article
DOI: 10.21608/geget.2021.49509.1016
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Authors
Faika Araborcid 1; Doaa Youssef email orcid 1; Fatma Alzahraa G. Ibrahim1; Lobna A. El-korashi2; Hoda Fathey3
1Department of Pediatrics, Pediatric Nephrology Unit, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
2Department of Medical Microbiology & Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
3Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
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
Nephrotic syndrome; B-lymphocyte; children; flow cytometry; steroid
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