Thyroid function in pediatric nephrotic syndrome: a hospital based observational study

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International Journal of Development Research

Thyroid function in pediatric nephrotic syndrome: a hospital based observational study

Abstract: 

Background: Nephrotic syndrome is a condition which is characterised by proteinurea, hypoprotenemia, hyperchlolesterolemia and significant edema. In children with nephrotic syndrome, it is probable to determine a hypothyroid state because of significant loss of thyroxine (T4), tri-iodothyronine (T3) and thyroid-binding globulin in presence of proteinuria.
Objectives: To determine the  thyroid function test  in pediatric cases of nephrotic syndrome, and to find any association and impact on thyroid harmone levels in these patients.
Methods: It was a prospective observational study from march 2012 to march 2014, thyroid function tests were performed in 208 patients which included both indoor and outdoor patients in the department of paediatrics Government Medical College, A tertiary care Pediatric Hospital.
Results: 122 cases identified as hypothyroid patients. There were 82 (67.2%) males and 40(32.8%) females with the mean age of 3.72±3.35 years. Our patients showed lowered T3 (68.3%) and T4 (64.4%) in comparison with normal values. Median TSH (Thyroid-stimulating hormone) was 11.65±6.71 Micu/ml and 2.82±0.82 in the hypothyroid and euthyroid patients respectively. In al, TSH was negatively correlated with the total urinary protein content.
Conclusions: According to this study, there is high incidence of hypothyroidism in patients of nephrotic syndrome and thus the occurrence of hypothyroidism in such children needs to be mentioned. It is proposed to systematicaly search hypothyroidism by measuring TSH and free T4 in these patients particularly when proteinuria is prolonged.

 

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