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Evaluation of thyroid profile among children aged 1-15 years with nephrotic syndrome: An observation study
Priyanka Kumari1, Amit Agrawal2, Jyotsna Shrivastava1
1Department of Pediatrics, Gandhi Medical College, Bhopal 462030, India.
Insights
Thyroid dysfunction is common in children with nephrotic syndrome, especially in frequent relapse cases. Early thyroid screening is recommended for timely detection and management of hypothyroidism in these patients.
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Clinical Medicine
Background:
- The kidneys and thyroid gland have a crucial bidirectional relationship.
- Nephrotic syndrome can lead to hypothyroidism due to protein loss through proteinuria.
Purpose of the Study:
- To evaluate thyroid function in pediatric patients diagnosed with nephrotic syndrome.
Main Methods:
- A cross-sectional study involving 70 children (aged 1-15 years) with nephrotic syndrome.
- Thyroid profile assessment including thyroid hormones and TSH levels.
- Analysis of thyroid status in newly diagnosed, relapsed, and frequently relapsed cases.
Main Results:
- Over half (55.7%) of patients exhibited abnormal thyroid profiles.
- Overt hypothyroidism was prevalent in 27.1% and subclinical hypothyroidism in 28.6%.
- Frequent relapses showed significantly lower free T3/T4 and higher TSH levels compared to newly diagnosed cases.
Conclusions:
- Abnormal thyroid function is frequent in pediatric nephrotic syndrome.
- Overt hypothyroidism is more common in children with frequent relapses.
- Routine thyroid screening is advised for early detection and management of hypothyroidism in nephrotic syndrome.
Background:
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.
Aim:
To assess the thyroid function in children with nephrotic syndrome.
Methods:
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.
Results:
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 (P < 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), (P < 0.01).
Conclusion:
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.
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