Afroz S, Khan A H, Roy D K
Department of Paediatric Nephrology, National Institute of Kidney Diseases & Urology, Sher-e Bangla Nagar, Dhaka, Bangladesh.
Mymensingh Med J. 2011 Jul;20(3):407-11.
This study was done to find out the thyroid function of nephrotic children during nephrosis and to compare any significant changes of thyroid function status during nephrosis and remission. This is an observational study with prospective follow up of study subjects. It was carried out over a period of one year from July'2006 to June'2007 in the department of Paediatric Nephrology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. A total of 85 nephrotic children with initial attack and relapse cases were studied. Age ranged from 2-12 years, M: F=1.7:1. All patients were clinically euthyroid. The mean value of serum T3 (0.65±0.31 ng/ml) and T4 (5.04±4.18 μg/ml) in 85 nephrotic children during nephrosis were within normal limit. But the mean value of thyroid stimulating hormone (TSH) was higher than normal level (7.1±5.8 MIU). In 21 nephrotic children thyroid function status was compared during nephrosis and 4 weeks later after achieving remission. A significant increase in TSH level during nephrosis (9.11±6.36 vs. 4.2±3.6 MIU/L, p = 0.005) was found, which normalized during remission. No significant difference between T3 and T4 level was observed. There was a negative correlation of serum albumin with serum TSH level (r = -0.216, p = 0.047). This result suggests that children with nephrotic syndrome commonly have a state of mild or subclinical hypothyroidism during proteinuria although they are clinically euthyroid. This temporary hypothyroid state improves with remission and needs no treatment.
本研究旨在了解肾病患儿在肾病期间的甲状腺功能，并比较肾病期间和缓解期甲状腺功能状态的任何显著变化。这是一项对研究对象进行前瞻性随访的观察性研究。研究于2006年7月至2007年6月在孟加拉国达卡国家肾脏疾病与泌尿外科研究所（NIKDU）儿科肾病科进行，为期一年。共研究了85例初发和复发的肾病患儿。年龄范围为2至12岁，男∶女 = 1.7∶1。所有患者临床甲状腺功能正常。85例肾病患儿在肾病期间血清T3（0.65±0.31 ng/ml）和T4（5.04±4.18 μg/ml）的平均值在正常范围内。但促甲状腺激素（TSH）的平均值高于正常水平（7.1±5.8 MIU）。对21例肾病患儿在肾病期间和缓解4周后的甲状腺功能状态进行了比较。发现肾病期间TSH水平显著升高（9.11±6.36 vs. 4.2±3.6 MIU/L，p = 0.005），缓解期恢复正常。未观察到T3和T水平有显著差异。血清白蛋白与血清TSH水平呈负相关（r = -0.216，p = 0.047）。该结果表明，肾病综合征患儿在蛋白尿期间通常处于轻度或亚临床甲状腺功能减退状态，尽管他们临床甲状腺功能正常。这种暂时性甲状腺功能减退状态在缓解期改善，无需治疗。
