Examine of Thyroid Function in Pediatric Nephrotic Syndrome; Tehran-Iran

Authors

1 Associated profesor of pediatric nephrology. Children’s Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran

2 Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

3 Pediatric Urology Research Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.

4 Resident of ophthalmology. Khatam Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

5 Resident of pediatrics. Department of Pediatrics, Children’s Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.

6 Resident of pediatrics. Department of Pediatrics, Children’s Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran

7 Resident of pediatrics. Department of Pediatrics, Children’s Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Introduction
In children with nephrotic syndrome, it is probable to determine a hypothyroid state because of thyroxine (T4), tri-iodothyronine (T3) and thyroid-binding globulin loss in presence of proteinuria.
Objectives: To examine thyroid function in pediatric cases of nephrotic syndrome.
Methods: In a cross-sectional study, from march 2010 to march 2012, thyroid function tests were performed in 104 patients referred to the nephrology department of children’s medical center, because of nephrotic  syndrome. Collected data analyzed with SPSS Statistics 17 and pResults: Sixty one cases identified as hypothyroid patients and were treated with supplementary levothyroxine. There were 41 (67.2%) males and 20 (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 all, TSH was negatively correlated with the total urinary protein content .
Conclusions: According to this study, the occurrence of hypothyroidism in any child with nephrotic syndrome needs to be mentioned. It is proposed to systematically search hypothyroidism by measuring TSH and free T4 in these patients particularly when proteinuria is prolonged.

Keywords


Introduction

Nephrotic syndrome is a glomerular disorder characterized by proteinuria greater than 2 grams per m2 per day, low level of serum albumin