Hypothyroidism in childhood idiopathic nephrotic syndrome / Heba Hany Mohamed Mohamed ; Supervised Samuel Helmy Makkar , Safaa Mohamed Abdelrahman , Dina Hesham Ahmed

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Thyroid status has not been studied well in children with idiopathic nephrotic syndrome (NS). Methods: A cross sectional study done on 110 child . 90 children aged from 2{u2013}15 years with NS ,62 males and 28 females in a ratio of 2.2:1 The age at onset of nephrotic syndrome ranged from 1.3to11 years with a median age of 4.75 years and the other 20 were healthy controls. Serum levels of FT3, FT4 and TSH were measured in all the subjects. Subclinical hypothyroidism was defined as an elevation in serum TSH with a normal serum FT4 concentration. The primary outcome measure was serum levels of FT3, FT4 and TSH in children with NS. Results : Children with NS had a higher level of TSH & lower level of FT4 compared to control group, where TSH mean in patients group was (2.7 ± 1.87æIU/ml ) while FT4 mean was (15.53 ± 2.13 pmol/l ). Twenty percent of the children (n = 18) with INS had subclinical hypothyroidism, Out of 18 children with subclinical hypothyroidism , 9 were in partial remission, 3 were in complete remission & 6 in relapse. Thirty percent of SRNS had sub clinical hypothyroidism with a TSH mean ± SD (3.99± 2.68) æIU/ml & normal Free T4 mean ± SD (17.03± 2.38) pmol/l where all were in relapse. Eighteen percent of SDNS had subclinical hypothyroidism, it was noticed that all patients in this type with subclinical hypothyroidism were in remission with TSH range 4.5-6.9 æIU/ml with mean ± SD (3.75± 2.1) æIU/ml & normal FT4 Conclusion: Subclinical hypothyroidism is present in a significant proportion of children with NS despite partial or complete remission.so thyroid profile should be evaluated routinely in this subset of patients

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