Kumari P, Agrawal A, Shrivastava J. Evaluation of thyroid profile among children aged 1-15 years with nephrotic syndrome: An observation study. World J Clin Pediatr 2024; 13(3): 94432 [PMID: 39350906 DOI: 10.5409/wjcp.v13.i3.94432]
Corresponding Author of This Article
Amit Agrawal, MD, Associate Professor, Department of Pediatrics, Gandhi Medical College, Hamidia Hospital Campus, 49-B, Indrapuri, B-Sector, Bhopal 462022, India. agrawaldramit@yahoo.co.in
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Sep 9, 2024; 13(3): 94432 Published online Sep 9, 2024. doi: 10.5409/wjcp.v13.i3.94432
Evaluation of thyroid profile among children aged 1-15 years with nephrotic syndrome: An observation study
Priyanka Kumari, Amit Agrawal, Jyotsna Shrivastava
Priyanka Kumari, Jyotsna Shrivastava, Department of Pediatrics, Gandhi Medical College, Bhopal 462030, India
Amit Agrawal, Department of Pediatrics, Gandhi Medical College, Hamidia Hospital Campus, Bhopal 462022, India
Author contributions: Kumari P contributed to acquisition and drafting the article; Shrivastava J contributed to drafting the article; Agrawal A contributed to conceptualization and revising the article critically for important intellectual content; Kumari P and Agrawal A contributed to interpretation of data, data analysis; Kumari P and Shrivastava J contributed to the literature review; All authors have critically reviewed and approved the final draft and are responsible for the content and similarity index of the manuscript.
Institutional review board statement: Approval was obtained from the Institutional Ethical Committee of the Gandhi Medical College, Bhopal (Letter No. ECR/1055/Inst/MP/2018, dated 04/01/2020).
Informed consent statement: The patients were recruited in the study after obtaining informed consent from the parent/legal guardian.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose.
Data sharing statement: The dataset is available upon reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amit Agrawal, MD, Associate Professor, Department of Pediatrics, Gandhi Medical College, Hamidia Hospital Campus, 49-B, Indrapuri, B-Sector, Bhopal 462022, India. agrawaldramit@yahoo.co.in
Received: March 18, 2024 Revised: June 4, 2024 Accepted: June 25, 2024 Published online: September 9, 2024 Processing time: 164 Days and 17.1 Hours
Abstract
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.
Core Tip: In nephrotic syndrome, proteinuria leads to loss of several proteins, which may lead to hypothyroidism. This cross-sectional study was conducted to assess the thyroid function in children with nephrotic syndrome aged 1-15 years. 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, 40% of second relapses, and 2.7% of frequently relapsed cases (P < 0.001). An abnormal thyroid profile was commonly observed in children with nephrotic syndrome, with overt hypothyroidism being more common in frequent relapse cases.
