Kumari Priyanka, Agrawal Amit, Shrivastava Jyotsna
Department of Pediatrics, Gandhi Medical College, Bhopal 462030, India.
Department of Pediatrics, Gandhi Medical College, Hamidia Hospital Campus, Bhopal 462022, India.
World J Clin Pediatr. 2024 Sep 9;13(3):94432. doi: 10.5409/wjcp.v13.i3.94432.
The interaction between the kidney and the thyroid is important for normal function of both organs. In nephrotic syndrome, proteinuria leads to loss of several proteins, which in turn causes hypothyroidism.
To assess the thyroid function in children with nephrotic syndrome.
This cross-sectional study was conducted in a tertiary center, Bhopal, from February 2020 to January 2021. Consecutive children aged 1-15 years admitted with nephrotic syndrome (first-time diagnosed and all relapse cases) were included in the study. A thyroid profile was sent along with routine investigations, and thyroid hormone status was assessed in nephrotic syndrome children.
Of the 70 patients, 39 (55.7%) showed abnormal thyroid profiles; 19 (27.1%) had overt hypothyroidism, and 20 (28.6%) had subclinical hypothyroidism. Overt hypothyroidism was seen in 16.1% of newly diagnosed cases, 40% of second relapses, and 2.7% of frequently relapsed cases ( < 0.001). The mean serum free T3 and free T4 levels in frequent relapses were 2.50 ± 0.39 ng/dL and 0.78 ± 0.12 ng/dL, respectively, which were significantly lower than in newly diagnosed cases (2.77 ± 0.37 ng/dL and 0.91 ± 0.19 ng/dL, respectively). The mean thyroid-stimulating hormone (TSH) level was significantly higher in frequent relapses 5.86 ± 1.56 µIU/mL) and second relapse (5.81 ± 1.78 µIU/mL) than in newly diagnosed cases (4.83 ± 0.76 µIU/mL) and first relapse cases (4.74 ± 1.17 µIU/mL), ( < 0.01).
An abnormal thyroid profile was commonly observed in children with nephrotic syndrome, and overt hypothyroidism was more common in frequent relapse cases. Therefore, thyroid screening should be a part of the management of nephrotic syndrome so that hypothyroidism can be detected and managed at an early stage.
肾脏与甲状腺之间的相互作用对两个器官的正常功能都很重要。在肾病综合征中，蛋白尿导致多种蛋白质流失，进而引起甲状腺功能减退。
评估肾病综合征患儿的甲状腺功能。
这项横断面研究于2020年2月至2021年1月在博帕尔的一家三级中心进行。研究纳入了1 - 15岁连续收治的肾病综合征患儿（首次诊断及所有复发病例）。在进行常规检查时同时检测甲状腺功能指标，对肾病综合征患儿的甲状腺激素状态进行评估。
70例患者中，39例（55.7%）甲状腺功能指标异常；19例（27.1%）为显性甲状腺功能减退，20例（28.6%）为亚临床甲状腺功能减退。显性甲状腺功能减退在16.1%的新诊断病例、40%的第二次复发病例以及2.7%的频繁复发病例中出现（<0.001）。频繁复发病例的平均血清游离T3和游离T4水平分别为2.50±0.39 ng/dL和0.78±0.12 ng/dL，显著低于新诊断病例（分别为2.77±0.37 ng/dL和0.91±0.19 ng/dL）。频繁复发病例（5.86±1.56 μIU/mL）和第二次复发病例（5.81±1.78 μIU/mL）的平均促甲状腺激素（TSH）水平显著高于新诊断病例（4.83±0.76 μIU/mL）和首次复发病例（4.74±1.17 μIU/mL）（<0.01）。
肾病综合征患儿中常见甲状腺功能指标异常，显性甲状腺功能减退在频繁复发病例中更为常见。因此，甲状腺筛查应作为肾病综合征管理的一部分，以便能早期发现并处理甲状腺功能减退。
