Urinary loss of thyroid hormones: An issue to remember

IF 1.8 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM
Ismael Capel , Loreley Betancourt , María Florencia Luchtenberg , Andreea Muntean , Valeria Arsentales , Judith Jover , Mercedes Rigla
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Abstract

A 45-year-old woman suffering from primary hypothyroidism, previously well substituted with levothyroxine, was urgently referred from Primary Care to Endocrinology due to very elevated thyrotropin, free thyroxine at low limit of normality, very high cholesterol and generalised oedema. Hypothyroidism was suspected as the main aetiology of this clinical condition. A detailed examination showed nephrotic range proteinuria and the patient was finally diagnosed with lupus nephritis. Urinary loss of thyroid hormones, fundamentally linked to their transport proteins, in patients affected by nephrotic syndrome is sometimes a forgotten phenomenon and one which should be considered in patients with increased levothyroxine requirements. In this report, we present the details of this case and a brief review of the literature on this topic.

甲状腺激素的尿流失:需要牢记的问题
一名 45 岁的妇女患有原发性甲状腺功能减退症,之前一直使用左甲状腺素替代治疗,但由于甲状腺素非常高、游离甲状腺素处于正常值的低限、胆固醇非常高以及全身水肿,她被紧急从初级保健科转诊到内分泌科。甲状腺功能减退症被怀疑是导致这种临床症状的主要病因。详细检查显示,患者出现肾病范围的蛋白尿,最终被诊断为狼疮性肾炎。肾病综合征患者尿中甲状腺激素的流失有时是一个被遗忘的现象,这与甲状腺激素的转运蛋白有着根本的联系,在患者对左甲状腺素的需求增加时应考虑到这一点。在本报告中,我们介绍了这一病例的详细情况,并简要回顾了有关这一主题的文献。
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来源期刊
CiteScore
2.10
自引率
10.50%
发文量
99
期刊介绍: Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954. The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines. It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories. The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published. The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor. Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.
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