Abstract
Nephrotic syndrome is known to induce significant changes in thyroid economy due to the increased thyroid hormones and thyronine-binding proteins urinary loss,without influences on euthyroid status(Gavin et al.JC EM,1978).In congenital nephrosis(CN),proteinuria starts in utero and is resistant to any treatment.CN is not generally reported as a cause of neonatal hypothyroidism;neverthless we observed biochemical and clinical evidence of hypothyroidism in 3 infants suffering from CN.In serum,taken from A.A.on the 5th day of life(proteinuria > 200 mg/hr/m2), TSH was 44 μU/ml,on the 15th day,TSH was 27 μU/ml,T4,4.6. μg/dl,T3,75 ng/dl, FT4,6.5 pg/ml,FT3,4.0pg/ml and TBG,11 μg/ml;Béclard nucleus was absent and a severe somatic and psycomotor retardation became evident during the first months of life. At the time of the first observation(5 months) showed clinical and biochemical features of hypothyroidism(T4,0.6 and 1.4 μg/dl, T3,50 and 85 ng/dl,respectively).In the three infants thyroid replacement therapy, started from 3 to 6 months, produced a meaningful improvement of clinical and biochemical features(A.A.12 months, TSH 12, T4 9,T3 200,TBG 18;P.D.10 months,TSH 25,T4 3.2,T3 190,TBG 10; V.D.9 months,TSH 13,T4 4.4,T3 150,TBG 12)in spite of persistent and marked proteinuria and thyroxinuria.
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De Luca, F., Trimarchi, F., Benvenga, S. et al. Congenital nephrosis cause of neonatal hypothyroidism. Pediatr Res 15, 84 (1981). https://doi.org/10.1203/00006450-198101000-00076
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DOI: https://doi.org/10.1203/00006450-198101000-00076