Nephrotic Syndrome as a Cause of Transient Clinical Hypothyroidism. (31st August 2021)

• Record Type: Journal Article
• Authors: Benido Silva, Vânia; Pereira, Maria Teresa; Moreira, Carla Leal; Santos Monteiro, Sílvia; Inácio, Isabel; Cardoso, Maria Helena
• Other Names: Boyanov Mihail A. Academic Editor.
• Is Part Of: Case reports in endocrinology. Volume 2021(2021)
• Publication Date: 2021-08-31
• Subjects: Endocrinology -- Periodicals; Endocrinology -- Case studies -- Periodicals; Endocrine glands -- Diseases -- Periodicals; Endocrinology; Endocrine System Diseases; Endocrine glands -- Diseases; Endocrinology; Electronic journals; Periodicals; Case studies; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; 616.4
• DOI: 10.1155/2021/5523929
• Languages: English
• ISSNs: 2090-6501

Abstract

Abstract : Nephrotic syndrome may trigger the onset of hypothyroidism, promoting massive urinary protein losses including thyroxine (T4) and triiodothyronine (T3) along with their binding proteins. At an early stage, a clinical and biochemical euthyroid state is expected. However, in patients with prolonged and severe proteinuria, especially with concomitant low thyroid reserve, urinary losses of free and protein-bound thyroid hormones are sufficiently pronounced to induce a subclinical or overt hypothyroidism. Despite its high prevalence in clinical practice, the literature lacks case reports of newly diagnosed clinical hypothyroidism due to NS in adults, making this condition under-recognized. We report a case of a 23-year-old man with previous normal thyroid function who developed overt hypothyroidism due to a severe nephrotic syndrome, requiring supplementation with levothyroxine (LT). After the patient had undergone bilateral nephrectomy, treatment with LT was discontinued and thyroid function normalized.