Abstract
In chronic renal failure we found central hypothyroidism (J Pediatric 1991; 118: 873), so we attempted to study thyroid hormone leveles, TSH/TRH response and the circadian TSH pattern in 9 children (9-16 years old) after renal transplantation (Tx), before and a year after substitution of methylprednisione (MP) with D. D is an oxazoline compound derived from prednisolone with similar antiinflammatory actions but fewer side effects. Renal fuction remained stable. Mean concentrations of T3 (2.3 ± 0.3 vs 2.3 ± 0.4 nmol/L), total T4 (112 ± 26 vs 110 ± 19 nmol/L) and basal TSH (3.4 ± 0.8 vs 2.8 0.9 mU/L) were normal; mean free T4 (13.4 ± 3.5 vs 14.2 ± 2.4 pmol/L) was low (p<0.01). Five patients on MP and 5 on D had deficient TSH increment to TRH; 3 out of patients on MP and 1 out of 5 on D had a nocturnal TSH surge below the normal range (47% - 300%). The association of low free T4, deficient TSH/TRH response and impaired nocturnal TSH surge, support the hypothesis that some renal transplant patients have central hypothyroidism. The circadian TSH pattern seems to improve on D therapy.
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Pasqualini, T., Fainstein-Day, P., Gutman, R. et al. 19 HYPOTHALAMIC-PITUITARY. THYROID ABNORMALITIES IN RENAL TRANSPLANT CHILDREN BEFORE AND AFTER DEFLAZACORT THERAPY. Pediatr Res 36, 675 (1994). https://doi.org/10.1203/00006450-199411000-00043
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DOI: https://doi.org/10.1203/00006450-199411000-00043