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Korean J Pediatr > Accepted Articles
DOI: https://doi.org/10.3345/kjp.2018.06891    [Accepted]
Published online October 4, 2018.
Changes in the Thyroid Hormone Profiles in Children with Nephrotic Syndrome
Sun Hee Jung  , Jeong Eun Lee, Woo Yeong Chung 
Department of Pediatrics, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
Correspondence:  Woo Yeong Chung, Tel: +82-51-890-6280, Fax: +82-51-895-7785, 
Email: chungwy@chol.com
Received: 22 August 2018   • Revised: 1 October 2018   • Accepted: 4 October 2018
Abstract
Purpose
We compared thyroid hormone profiles in children with nephrotic syndrome (NS) at nephrotic phase and after remission.
Methods
This study included thirty-one pediatric NS patients. Thyroid hormone profiles consist of serum T3, T4, TSH and free T4.
Results
Of the 31 patients, 16 (51.6%) showed abnormal findings in their thyroid hormone profiles: six, overt hypothyroidism; eight, subclinical hypothyroidism, and two, low T3 syndrome. The mean serum T3, T4, and free T4 levels were 82.37±23.64 ng/dL and 117.88±29.49 ng/dl, 5.47±1.14 µg/dl and 7.91±1.56 µg/dl, and 1.02±0.26 ng/dl and 1.38±0.23 ng/dl at NS nephrotic phase and remission, respectively, and were significantly lower at NS nephrotic phase (P=0.0007, <0.0001, and 0.0002). The mean serum TSH level at NS nephrotic phase and remission was 8.05±3.53 µIU/mL and 4.08±2.05 µIU/mL, respectively, and was significantly higher at NS nephrotic phase (P=0.0005). The urinary protein/creatinine ratio at NS nephrotic phase was significantly correlated with serum T3, T4, and free T4 levels (r=-0.5995, P=0.0032; r=-0.5797, P=0.0047; r=-0.5513, P=0.0078) as well as with TSH levels (r=0.5022, P=0.0172). A significant correlation was found between serum albumin levels and serum T3 levels at NS nephrotic phase (r=0.5385, P=0.0018) but not between serum albumin and T4, TSH, or free T4 levels. These significant correlations were all disappeared after remission.
Conclusion
Thyroid hormone profile abnormal findings were observed in 51.6% of pediatric patients with NS. Thyroid hormone levels normalized after remission, regardless of levothyroxine therapy.
Key Words: Thyroid gland, Nephrotic syndrome, Thyroid hormones, Child


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