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Biochemical hypothyroidism in Nigerian children with nephrotic syndrome
Insights
Children with nephrotic syndrome in Nigeria, often linked to malaria, show signs of primary hypothyroidism. This study found low thyroxine and high TSH levels in these patients.
Area of Science:
- Pediatrics
- Endocrinology
- Nephrology
Background:
- Nephrotic syndrome in Nigerian children is frequently associated with quartan malaria.
- Thyroid function in children with nephrotic syndrome requires further investigation.
Purpose of the Study:
- To investigate thyroid function in Nigerian children diagnosed with nephrotic syndrome.
- To compare thyroid hormone levels in nephrotic children with healthy controls.
Main Methods:
- Thyroid function tests were performed on 24 children (4-14 years) with active nephrotic syndrome.
- Measurements included total serum thyroxine, T3 resin uptake, free thyroxine index (FTI), and thyrotropin (TSH).
- Results were compared to 181 age-matched healthy children.
Main Results:
- Nephrotic children exhibited significantly lower mean total serum thyroxine (50.0 nmol/l) and FTI (16.7) compared to controls (118.3 nmol/l and 34.7, respectively).
- T3 resin uptake was slightly higher in nephrotic children (33.1%) than controls (29.8%).
- Mean TSH levels were elevated in nephrotic children (10.6 mU/l) compared to controls (4.8 mU/l).
Conclusions:
- The study suggests a state of primary hypothyroidism in Nigerian children with nephrotic syndrome.
- Low thyroxine and FTI, coupled with high TSH, indicate impaired thyroid function in this pediatric population.
Abstract:
The nephrotic syndrome in Nigerian children is known to be largely associated with the endemicity of quartan malaria. Routine thyroid function studies were carried out on 24 children with clinical and biochemical evidence of the nephrotic syndrome. The children, aged four to 14 years, were all in the active phase of their disease, presenting with facial and pedal oedema and ascites. There was severe hypoalbuninaemia [mean (S.E.); 19.2 (1.1) g/l], hypercholesterolaemia; 10.5 (1.0) mmol/l and severe albuminuria ranging from 1 to 10 g/l. There was no clinical evidence of thyroid disease. The results of thyroid function tests in these children were compared with those of 181 apparently healthy children of the same age range. The mean total serum thyroxine levels (S.E.) were 118.3 (2.6) and 50.0 (6.4) nmol/l in controls and patients, respectively; T3 resin uptake values were 29.8 (0.2)% and 33.1 (1.2)%; the free thyroxine index (FTI) was 34.7 (0.8) and 16.7 (1.9) while thyrotropin (TSH) levels were 4.8 (0.2) and 10.6 (1.0) mU/l (IRP. MRC 68/38), respectively. The findings of low levels of thyroxine and FTI in association with high levels of TSH suggest that a state of primary hypothyroidism exists in these nephrotic children.