DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20184298

Thyroid function test in nephrotic syndrome children who are admitted in emergency ward of Government Tirunelveli Medical College and Hospital, India

J. Rukmani, C. Krishanamurthy, Denny Clarin

Abstract


Background: Nephrotic syndrome in childhood is largely primary or idiopathic, although a small proportion of cases are secondary to infectious agents and other glomerular and systemic diseases. The etiology of nephrotic syndrome is age-dependent. Most cases appearing in the first 3 months of life are referred as congenital nephrotic syndrome (CNS) and are due to genetic diseases. The objective of this study is to study the correlation between thyroid profile and different types of nephrotic syndrome.

Methods: This cross-sectional study was done between March 2017 to October 2017 in the Department of Pediatrics Tirunelveli Government Medical College. 40 cases of nephrotic syndrome between 1 to12 years, which include all types of nephrotic syndrome. After history taking and clinical examination, blood samples were collected from the patients for thyroid function test and analyzed with standard techniques.

Results: Serum T3, T4, TSH were found to be within normal limits. But TSH values in remission were significantly elevated compared to the first episode.

Conclusions: Thyroid profiles in control were within normal range. The T4 and T3 levels in nephrotic syndrome were low and TSH was high. Hypothyroidism was more common in children less than 6 years. 


Keywords


Nephrotic syndrome, Steroid-Resistant Nephrotic Syndrome (SRNS), Steroid-Dependent Nephrotic Syndrome (SDNS), Thyroid function test.

Full Text:

PDF

References


Boute N, Gribouval O, Roselli S et al. NPHS2, encoding theglomerular protein podocin, is mutated in autosomal recessivesteroid-resistant nephrotic syndrome. Nat Genet 24:349, 2000.

Churg J, White RH. Pathology of the nephroticsyndrome in children: a report for the International Study of Kidney Disease in Children. 1999,760:1299,

Habib R, White RH. Nephrotic syndrome and interstitial nephritis associated with celecoxib. Am J Kidney Dis. 2002;40:1086.

Elger M. Podocytes and the development of segmental glomerulosclerosis. Nephrol Dial Transplant. 1988;13:1368.

Kriz W. Proteinuria and focal segmental glomerulo sclerosis in severely obese adolescents. J Pediatr. 2001;138:481.

Esnault VL, Besnier D, Testa A. Effect of protein A immuno adsorption in nephrotic syndrome of various etiologies. J Am Soc Nephrol. 2011:20-5.

Guo JK, Menke AL, Gubler MC. WT1 is a key regulator of podocyte function: reduced expression levels cause crescentic glomerulo nephritis and mesangial sclerosis. Hum Mol Genet. 2002;11:651-4.

Hara M, Yanagihara T, Kihara I. Urinary podocytes in primary focal segmental glomerulosclerosis. Nephron. 2001;89:342-5.

Hara M, Yanagihara T, Takada T. Urinary excretion of podocytes reflects disease activity in children with glomerulonephritis. Am J Nephrol. 1988;18:35-7.

Kaplan JM, Kim SH, North KN. Mutations in ACTN4, encodingalpha-actinin-4, cause familial focal segmental glomerulosclerosis. Nature Genetics. 2000;24(3):251.

Kestila M, Lenkkeri U, Mannikko M. Positionally cloned the gene for a novel glomerular protein: nephrin-is mutated incongenitalnephrotic syndrome. Molecular cell. 1998;1(4):575-82.

Kriz W, Gretz N, Lemley KV. Progression of glomerular diseases: is the podocyte the culprit? Kidney Int. 2008;1(4):123-15.

Niaudet P. Steroid sensitive idiopathic nephrotic syndrome in children. In: Avner ED, Harmon WE, eds. Pediatric Nephrology. Philadelphia: Williams and Wilkins; 2004:543-545.

Pelletier J, Bruening W, Kashtan CE. Germline mutations in the Wilms’ tumor suppressor gene are associated with abnormal urogenital development in Denys–Drash syndrome. Cell. 1991;67(2):437-47.

Sharma M, Sharma R, McCarthy ET. The FSGS factor: enrichment and in vivo effect of activity from focal segmental glomerulo-sclerosis plasma. J Am Soc Nephrol. 2011;10:552-3.

Sharma M, Sharma R, Reddy SR, McCarthy ET, Savin VJ. Proteinuria after injection of human focal segmental glomerulosclerosis Factor 12. Transplant. 2002;73(3):366-72.

Usberti M, Gazzotti RM, Poiesi C. Considerations on the sodium retention in nephrotic syndrome. Am J Nephrol. 2011:56-59

Van den Born J, Van den Heuvel LPWJ, Bakker MAH et al. A monoclonal antibody against GBM heparin sulfate induces an acute selective proteinuria in rats. Kidney Int. 2011;41:115.

Ozdamar SO, Gucer S, Tinaztepe K. Hepatitis-B virus associated nephropathies: a clinicopathological study in 14 children. Pediatr Nephrol. 2003;18:23-7.

Moorthy AV, Zimmerman SW, Burkholder PM. Nephrotic syndrome in Hodgkin’s disease. Evidence for pathogenesis alternative to immune complex deposition. Am J Med. 1999;61:471-8.