Antibody formation following botulinum toxin type A (Dysport) injection in children with intractable bladder hyper-reflexia.

Abstract:

OBJECTIVES:To investigate the pattern of anti-Dysport antibody (ADA) formation after Dysport injection in patients with neuropathic bladder. Antibody formation may lead to failure or allergic reactions in patients undergoing Dysport injection. METHODS:Forty-four children with neuropathic bladder were enrolled and classified into 3 groups: group I, without history of previous injection (n = 8); group II, with history of one or more injections (n = 7); and group III, who had been injected 3-36 months before this study (n = 29). Groups I and II were subjected to Dysport injection. Fifty-five age-matched healthy children were selected as controls. Urinary incontinence score was assessed before and 6 months after injection. Under cystoscopic guidance, Dysport (10 IU/kg) was injected into the detrusor muscle, sparing the trigone and ureteral orifices. ADA level was measured by enzyme-linked immunosorbent assay technique before injection and then monthly for at least 4 months in groups I and II, and for just once in group III and control subjects. RESULTS:ADA level was increased 1-2 months after the last injection in 3 (38%) of group I and 5 (71%) of group II. However, ADA level in group III was not higher than controls. All patients had complete or partial improvement in urinary incontinence score except for 1 patient in group I. No resistance to treatment was detected. CONCLUSIONS:Increment of ADA titer in patients is not permanent. Repeated injections will not boost the immune system to produce higher levels of antibody. Increased levels of ADA may not be associated with treatment failure at follow-up visit.

journal_name

Urology

journal_title

Urology

authors

Kajbafzadeh AM,Nikfarjam L,Mahboubi AH,Dianat S

doi

10.1016/j.urology.2010.03.023

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

233-7

issue

1

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(10)00358-4

journal_volume

76

pub_type

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