Thyroid status in children with steroid sensitive nephrotic syndrome

Abstract

Introduction: Nephrotic syndrome (NS) is one of a major illness in childhood which needs prolonged immunosuppressive therapy due to its relapsing nature. Thyroid hormones and thyroxin-binding globulin (TBG) are known to lose in patients with NS. The main objectives of this research was to study the thyroid profile among the children with nephrotic syndrome during nephrosis and remission. Methods: An observational analytical study was carried out among total of 65 children with NS who were attending to University Nephrology Clinic, Teaching Hospital Karapitiya. Demographic details of patients and their relevant clinical details were obtained by an interviewer administered questionnaire. Blood for free T4, TSH, serum Albumin and Cholesterol were taken together and kept in -80 C after separating serum. Results; There were 35 and 30 patients in remission and in relapses respectively. Out of all 55.4% (n= 36) were males. The mean age in remission and relapse groups were 86.9 months ± 42.0 and 85.73 months ± 38.45. The proportions of patients who were on prednisolone, cyclophosphamide and cyclosporine were 92.3% (n=60), 21.5% (n=14) and 3.1% (n=2). The mean TSH levels in remission group and relapse group were 1.99 ±1.02 mIU/L and 4.69 ± 2.99 mIU/L respectively (P= < 0.001). There was no statistical difference (P= 0.36) in the mean free T4 level of the remission group (1.084± 0.50) ng/dL compared to that of the relapse group (1.23±0.74) ng/dL. In contrast, total protein and serum albumin levels were significantly lower in the relapse group whereas, serum cholesterol was significantly higher (P=0.001) in the remission group. Conclusion; In conclusion, though subclinical hypothyroidism is evident in children with steroid sensitive nephrotic syndrome at the time of proteinuria, clinical or subclinical hypothyroidism do not exist among those who were in remission.

Keywords

• thyroid profile, nephrotic syndrome, children