Bilateral nephrectomy reverses hypothyroidism in congenital nephrotic syndrome
Bilateral nephrectomy reverses hypothyroidism in congenital nephrotic syndrome
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DOI：
10.1007/s004670050594
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发表时间：
1999-04-01
影响因子：
3
通讯作者：
Alon, US
中科院分区：
文献类型：
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作者：
Chadha, V;Alon, US
先天性肾病综合征(NS)的婴儿通常会出现一种生化甲状腺功能减退的状态，因此目前的建议是对所有先天性NS患者进行补充甲状腺制剂。我们报告了5例先天性肾病综合征儿童的经验，在双侧肾切除和开始肾脏替代治疗后停止了甲状腺补充。肾切除后，甲状腺功能测试立即恢复正常，但血清促甲状腺激素(TSH)浓度最初上升，但后来恢复正常。这一观察结果支持了这样的假设，即这些患者的甲状腺功能减退是慢性大量蛋白尿的继发性疾病，而不是甲状腺本身固有缺陷的结果。大量蛋白尿的减少使得停止补充甲状腺成为可能，而TSH在肾切除术后早期的一过性升高是可以预见的。
A state of biochemical hypothyroidism is commonly seen in infants with congenital nephrotic syndrome (NS) and therefore the current recommendation is to place all patients with congenital NS on supplemental thyroid preparations. We report our experience in five children with congenital NS in whom thyroid supplementation was discontinued following bilateral nephrectomy and initiation of renal replacement therapy. Immediately after nephrectomy, thyroid function tests normalized, except serum thyroid-stimulating hormone (TSH) concentration, which initially rose, but normalized later. This observation supports the hypothesis that hypothyroidism in these patients is secondary to the chronic massive proteinuria and is not the result of a defect intrinsic to the thyroid gland itself. Abatement of massive proteinuria enables discontinuation of thyroid supplementation, and a transient rise in TSH in the early post-nephrectomy stage should be potentially expected.