Assessment of the level of vaccine-induced anti-HBs antibodies in children with inflammatory systemic connective tissue diseases treated with immunosuppression

Abstract Objectives: Protective vaccinations are the most effective method of prevention of type B virus hepatitis. The aim of the study was to determine whether in children receiving immunosuppressive therapy due to inflammatory systemic connective tissue diseases the protective concentration of the anti-HBs antibodies produced after vaccination against type B virus hepatitis in infancy is maintained. Material and methods: The concentration of anti-HBs antibodies was assessed in the sera of 50 children with inflammatory connective tissue diseases -37 girls (74%) and 13 boys (26%), aged 1.5-17.5 years -during the immunosuppressive treatment, which lasted at least 6 months. The control group consisted of 50 healthy children -28 girls (56%) and 22 boys (44%) aged 2-17 years. All children were vaccinated in infancy with Engerix B vaccine according to the 0-1-6 months schedule. The antibody concentration of ≥ 10 mIU/ml in patients is regarded as protective. Results: No protective antibody concentrations were found in 25 cases (50%) in the group of diseased children and only in 2 children in the control group (4%). Conclusions: The concentration of vaccine-induced antibodies should be assessed in children with inflammatory systemic connective tissue diseases and, in case of the absence of a protective concentration, revaccination should be started. The use of glucocorticosteroids, synthetic and biological disease-modifying antirheumatic drugs is no contraindication to vaccination against hepatitis B

Progressive pseudorheumatoid arthropathy of childhood – do we know this disease?ująca rzekomoreumatoidalna artropatia dziecięca

Progressive pseudorheumatoid arthropathy of childhood (PPAC) is an inherited autosomal recessive skeletal dysplasia. The disease is associated with mutations of the gene WISP 3. Primarily it is a disorder of articular cartilage, followed by degeneration and loss of articular cartilage. The initial clinical symptoms, which usually appear between 3 and 8 years of age, are similar to the symptoms of juvenile idiopathic arthritis. The main features are progressive, non inflammatory arthropathy of minor and major joints and changes in the spine. Gradually there occurs enlargement of joints, then progressive restriction of joint and spine mobility. Radiographic imaging, the most important for diagnosis, revealed widened epiphyses and metaphyses of bones, generalized osteoporosis of bones, and narrowing of articular spaces. In the spine platyspondyly and narrow intervertebral disc spaces are typical. In differential diagnosis it is essential to exclude juvenile idiopathic arthritis, but also other connective tissue diseases, spondyloarthropathies, mucopolysaccharidoses, and inherited bone dysplasias

Original paper Assessment of the level of vaccine-induced anti-HBs antibodies in children with inflammatory systemic connective tissue diseases treated with immunosuppression

Objectives : Protective vaccinations are the most effective method of prevention of type B virus hepatitis. The aim of the study was to determine whether in children receiving immunosuppressive therapy due to inflammatory systemic connective tissue diseases the protective concentration of the anti-HBs antibodies produced after vaccination against type B virus hepatitis in infancy is maintained. Material and methods : The concentration of anti-HBs antibodies was assessed in the sera of 50 children with inflammatory connective tissue diseases – 37 girls (74%) and 13 boys (26%), aged 1.5–17.5 years – during the immunosuppressive treatment, which lasted at least 6 months. The control group consisted of 50 healthy children – 28 girls (56%) and 22 boys (44%) aged 2–17 years. All children were vaccinated in infancy with Engerix B vaccine according to the 0–1–6 months schedule. The antibody concentration of ≥ 10 mIU/ml in patients is regarded as protective. Results: No protective antibody concentrations were found in 25 cases (50%) in the group of diseased children and only in 2 children in the control group (4%). Conclusions : The concentration of vaccine-induced antibodies should be assessed in children with inflammatory systemic connective tissue diseases and, in case of the absence of a protective concentration, revaccination should be started. The use of glucocorticosteroids, synthetic and biological disease-modifying antirheumatic drugs is no contraindication to vaccination against hepatitis B