Thyroid hormone status in childhood nephrotic syndrome: An experience from Central India

ABSTRACT Background: Children with nephrotic syndrome (NS) are susceptible to subclinical or overt hypothyroidism due to massive urinary excretion of albumin, binding proteins, thyroid hormone, and chronic steroid therapy. Objective: The objective of this study was to estimate the thyroid hormone status in children with NS. Materials and Methods: A cross-sectional observational study was conducted on 50 children diagnosed with NS for a period of 1 year at Government Medical College, Nagpur, Maharashtra. Demographic, clinical, and laboratory data were collected. Thyroid hormone (thyroid-stimulating hormone, T3, T4, free T3, and free T4) assessment was done by electrochemiluminescence technology. Independent t -test and Chi-square test were used for statistical analysis. Results: Males and females were almost equal, and more than half of the children were below 5 years of age. More than three-quarters were steroid responsive, and 62% had their first episode. Hypothyroidism was noted in 38% of children. Among them, 28% had subclinical, and 10% had overt hypothyroidism. The mean levels of total protein, serum albumin, and serum globulin were significantly lower in hypothyroid compared to euthyroid children with NS ( P < 0.0001). Conclusion: The prevalence of hypothyroidism in this study was 38%; 28% had subclinical and 10% had overt hypothyroidism. Screening for thyroid hormone is an important part of the management of children with NS.