Thyroid Dysfunction During Active Disease in Pediatric Nephrotic Syndrome: A Case Series and Clinical Management Approach

Background: Nephrotic syndrome (NS) in children is associated with several extrarenal complications, including thyroid dysfunction. Urinary losses of thyroid hormones and thyroid binding proteins during active disease may result in subclinical or overt hypothyroidism.

Case presentation: We report a case series of three children with nephrotic syndrome admitted in January 2025, April 2025, and January 2026 who developed thyroid dysfunction during the active phase of nephrotic syndrome. Baseline clinical characteristics and thyroid function parameters before treatment and after remission are summarized in Table 1.

Results: Two children had subclinical hypothyroidism, while one had overt hypothyroidism with clinical symptoms. Subclinical hypothyroidism resolved spontaneously following remission of nephrotic syndrome, whereas overt hypothyroidism required temporary levothyroxine therapy. Thyroid function normalized in all children after achievement of remission.

Conclusion: Thyroid dysfunction in pediatric nephrotic syndrome is often transient and closely related to disease activity