Serum IgE levels are a risk factor with prognosis of pediatric minimal change disease

Tingting Han; Mei Xue; Yafei Guan; Tao Ju; Kaili Shi; Mengzhen Fu; Lili Jia; Chunlin Gao; Zhengkun Xia

doi:10.3389/fped.2023.1234655

Serum IgE levels are a risk factor with prognosis of pediatric minimal change disease

Front Pediatr. 2023 Jul 25:11:1234655. doi: 10.3389/fped.2023.1234655. eCollection 2023.

Authors

Tingting Han^#^{1

2}, Mei Xue^#³, Yafei Guan^#^{1

2}, Tao Ju¹, Kaili Shi¹, Mengzhen Fu¹, Lili Jia⁴, Chunlin Gao^{1

4}, Zhengkun Xia^{1

4}

Affiliations

¹ Department of Pediatrics, Jinling Hospital, Nanjing Medical University, Nanjing, China.
² Department of Pediatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
³ Department of Pediatrics, Taizhou People's Hospital Affiliated to Nanjing Medical University, Taizhou, China.
⁴ Department of Pediatrics, Jinling Hospital, Nanjing, China.

^# Contributed equally.

Abstract

Background: Minimal change disease (MCD) is one of the most common primary glomerular disorders with high serum IgE levels. This study was aimed to investigate the clinical features of different serum IgE levels in pediatric MCD and evaluate the prognostic significance of serum IgE levels with regard to remission and relapse in pediatric cohort.

Methods: This study enrolled 142 new-onset children diagnosed with biopsy-proven MCD from January 2010 to December 2021 at the Jinling Hospital in Nanjing, China. These cases were divided into three groups according to serum IgE levels. MCD patients' demographics, clinical parameters, and follow-up data were collected and analyzed. The primary and secondary outcomes were defined as the time to the first complete remission (CR) and the first relapse.

Results: The results manifested that 85.2% (121/142) of MCD children had high serum IgE levels (IgE > 90.0 IU/ml). A total of 142 patients were divided into the normal-, low-, and high-IgE groups based on the normal reference value level (90.0 IU/ml) and median serum IgE level (597.5 IU/ml). The high-IgE group had a significantly lower cumulative rate of the first CR (log-rank, P = 0.032) and a higher rate of the first relapse (log-rank, P = 0.033) than the normal-IgE and low-IgE groups. Multivariate Cox analysis showed that IgE ≥597.5 IU/ml was independently associated with the delayed first CR [hazard ratio (HR) = 0.566, 95% confidence interval (CI) = 0.330-0.972, P = 0.039] and the early first relapse (HR = 2.767, 95% CI = 1.150-6.660, P = 0.023).

Conclusions: Serum IgE levels were an independent correlation factor for pediatric MCD-delayed remissions and early relapses.

Keywords: children; minimal change disease; relapse; remission; serum IgE.

Grants and funding

This work was supported by the Pediatric Medical Innovation Team of Jiangsu Province (CXTDA2017022), key funding project of maternal and child health research project in Jiangsu Province (F201813), and pediatric medical research special fund project of Jiangsu Medical Association(SYH-32034-0076(20230023)).