Agras Pinar Isik, Kinik Sibel Tulgar, Cengiz Nurcan, Baskin Esra, Saatci Umit
Pediatric Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
J Pediatr Endocrinol Metab. 2005 Mar;18(3):319-22. doi: 10.1515/jpem.2005.18.3.319.
The association of renal disease and autoimmune thyroid disorders has been reported previously. Renal findings associated with autoimmune thyroiditis present more commonly as proteinuria ranging from mild to nephrotic levels. We report here two adolescent girls with hyperthyroidism associated with transient proteinuria correlated with thyroid hormone levels. They had positive antithyroid peroxidase and antithyroglobulin antibodies. Ultrasonographic and scintigraphic findings of the thyroid gland were consistent with Graves' disease in both. Their renal functions were normal except proteinuria (daily protein excretion of 13.5 mg/m2/h in patient 1 and 11 mg/m2/h in patient 2). When they became euthyroid on antithyroid treatment, proteinuria decreased without associated hematuria and/or hypertension. In conclusion, patients with autoimmune thyroid disease should be assessed for the possibility of proteinuria and the etiological investigation of proteinuria should include evaluation of thyroid functions.
肾病与自身免疫性甲状腺疾病之间的关联此前已有报道。与自身免疫性甲状腺炎相关的肾脏表现更常见为蛋白尿,程度从轻度到肾病水平不等。我们在此报告两名患有甲状腺功能亢进症且伴有与甲状腺激素水平相关的短暂蛋白尿的青春期女孩。她们的抗甲状腺过氧化物酶和抗甲状腺球蛋白抗体呈阳性。两名患者甲状腺的超声和闪烁扫描结果均与格雷夫斯病相符。除蛋白尿外,她们的肾功能正常(患者1每日尿蛋白排泄量为13.5 mg/m²/h,患者2为11 mg/m²/h)。当她们接受抗甲状腺治疗后甲状腺功能恢复正常时,蛋白尿减少,且未伴有血尿和/或高血压。总之,自身免疫性甲状腺疾病患者应评估蛋白尿的可能性,蛋白尿的病因调查应包括甲状腺功能评估。