Mattoo T K
Paediatric Renal Service, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.
Pediatr Nephrol. 1994 Dec;8(6):657-9. doi: 10.1007/BF00869078.
Thyroid function indices were studied in five children with nephrotic syndrome in the 1st year of life. Four had primary hypothyroidism as defined by low serum free tri-iodothyronine (FT3) and free thyroxine (FT4), and high serum thyroid-stimulating hormone (TSH) levels. One patient with low serum FT3 and FT4 had a normal TSH level. T4 replacement therapy lowered TSH to normal levels in all four patients and normalized FT4 in three of them. There were no significant changes in serum FT3 levels. Adrenal function was studied in three patients, none had adrenal calcification or hypoadrenocorticism. This study supports the existence of a hypothyroid state in some infants with nephrotic syndrome. Routine thyroid screening and early replacement therapy is recommended.
对5名1岁以内患肾病综合征的儿童进行了甲状腺功能指标研究。4名患儿血清游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）水平低，血清促甲状腺激素（TSH）水平高，符合原发性甲状腺功能减退症的定义。1名血清FT3和FT4水平低的患者TSH水平正常。4名患者接受T4替代治疗后TSH降至正常水平，其中3名患者的FT4恢复正常。血清FT3水平无显著变化。对3名患者进行了肾上腺功能研究，均未发现肾上腺钙化或肾上腺皮质功能减退。本研究支持部分肾病综合征婴儿存在甲状腺功能减退状态。建议进行常规甲状腺筛查并尽早进行替代治疗。
