title: Subclinical non-autoimmune hypothyroidism in children with steroid resistant nephrotic syndrome.
abstract: BACKGROUND
  Thyroid status has not been studied well in children with steroid resistant nephrotic syndrome (SRNS).
  
  
  METHODS
  In this cross sectional study we recruited 20 children aged 1-16 years with SRNS and similar number of controls. Serum levels of FT3, FT4 and TSH were measured in all the subjects. Overt hypothyroidism was defined as low FT4 (normal values: 0.7-2.0 ng/mL) and elevated serum TSH above reference values (0.45-4.5 mIU/L). Subclinical hypothyroidism (SH) 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 SRNS.
  
  
  RESULTS
  Thirty per cent of the children (n = 6) with SRNS had non-autoimmune subclinical hypothyroidism (2 children each with grade I, II and III). Children with SRNS had a median TSH value [3.9 mIU/L (0.5-13)] within normal range, but levels were high as compared to controls. Out of 6 children with SH, 3 were in partial remission, 3 were in complete remission. The TSH levels normalized on thyroxine supplementation in grades II and III subclinical hypothyroidism.
  
  
  CONCLUSIONS
  Subclinical non-autoimmune hypothyroidism is present in a significant proportion of children with SRNS despite partial or complete remission. Thyroid profile should be evaluated routinely in this subset of patients.
authors.affiliation: Department of Pediatrics, Postgraduate Institute of Medical Education and Research associated Dr Ram Manohar Lohia Hospital, Room no 406, PGIMER Building, New Delhi, 201010, India.
authors.forename: Kanika
authors.initials: K
authors.lastname: Kapoor
authors.forename: Abhijeet
authors.initials: A
authors.lastname: Saha
authors.forename: N K
authors.initials: NK
authors.lastname: Dubey
authors.forename: Parul
authors.initials: P
authors.lastname: Goyal
authors.forename: C P
authors.initials: CP
authors.lastname: Suresh
authors.forename: Vinita
authors.initials: V
authors.lastname: Batra
authors.forename: Ashish Dutt
authors.initials: AD
authors.lastname: Upadhayay
mesh_terms: D000293:Adolescent; D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D007223:Infant; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy; D012074:Remission Induction; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000097:blood
chemical_list: D015415:Biomarkers; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine