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Consumptive hypothyroidism hemangioma of liver – Severe consumptive hypothyroidism caused by multiple infantile hepatic haemangiomas

Subsequent to this, thyroid function tests confirmed an associated but comparatively rare form of hypothyroidism, known as consumptive hypothyroidism.

Oxford Academic. We present a yr-old female with a large hepatic vascular tumor and subclinical hypothyroidism. Thyroid ;15 8 — Case report: Consumptive hypothyroidism consequent to multiple infantile hepatic hemangiomas. Although some observers believed the tumor in this patient to be an epithelioid hemangioendothelioma, others felt that it was not fully characteristic and that a diagnosis of hemangioendothelioma not otherwise specified seemed most appropriate 5 — 8.

  • Severe hypothyroidism caused by type 3 iodothyronine deiodinase in infantile hemangiomas. The goiter, thyroid hypervascularity, marked hyperthyrotropinemia, and serum rT 3 elevation all resolved or normalized after removal of the liver Table 1.

  • The TFTs were at normal reference levels. Imaging identified innumerable hepatic hemangiomas, consistent with diffuse infantile hepatic hemangiomatosis.

  • Hepatic hemangioma is a commonly encountered benign vascular tumour of liver during infancy. She had an ejection systolic murmur.

  • J Pediatr Surg. Abstract Consumptive hypothyroidism is a rare paraneoplastic syndrome characterized by excessive inactivation of the thyroid hormones due to increased type 3 iodothyronine deiodinase activity of tumors.

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Subjects and Methods

Substances Thyroid Hormones Thyroxine. Abstract Background Infantile hepatic haemangiomas IHHs produce an excess of the thyroid hormone inactivating enzyme type-3 iodothyronine deiodinase D3leading to rapid degradation of thyroid hormones and consumptive hypothyroidism. Email: preetid sgpgi. Intractable cases need hepatic artery embolization, segmental resection or liver transplantation.

Fish, David M. Funding: None; Competing interest: None stated. Thyroid US showed a eutopic gland of normal size and echogenicity. Huang SA. The TFTs were at normal reference levels.

Infantile hemngioma hemangioma IHH -related consumptive hypothyroidism is rare and occurs as a result of excess thyroid hormone inactivating enzyme, type-3 iodothyronine deiodinase. We describe a child who presented with severe hypothyroidism secondary to consumption by an IHH. Spectrum of hepatic hemangiomas: management and outcome. Substances Adrenergic beta-Antagonists Thyroxine. The association of consumptive hypothyroidism secondary to hepatic hemangioma and severe heart failure in infancy. A 2-month-old Japanese male was referred to our hospital because of jaundice.

Journal and Issue

Ann Clin Biochem ;48 Pt 2 — The resected liver weighed 4. He showed normal growth height, 70 cm; weight, 8. Sitemap What's New Feedback Disclaimer.

Thyroid hormone liger. Clin Pediatr Endocrinol. The levothyroxine dose was increased to A 3-month-old female baby presented with severe constipation for the past one month. J Pediatr : — Contrast-enhanced CT scan showed these lesions to have early enhancement with persistence in delayed phase consistent with a diagnosis of IHH Fig.

Thyroid function tests should be performed henangioma short liver and the test results monitored for dose titration to avoid iatrogenic hyperthyroidism. One or two layers of plump pericytes were present. David M. The tumoral D3 expression in these vascular lesions together with the disappearance of hypothyroidism after hemangioma involution support the concept that this endocrinopathy is due to an excessive degradation rate of thyroid hormone relative to the functional reserve of the infant thyroid. Drug Therapy, Combination.

Publication types

Physical examination revealed pallor, depressed nasal bridge and macroglossia. Related citations. Clinical management of childhood hyperthyroidism with and without Down syndrome: a longitudinal study at a single center.

  • Journal of Pediatric Endocrinology and Metabolism, Vol. Abstract Background Infantile hepatic haemangiomas IHHs produce an excess of the thyroid hormone inactivating enzyme type-3 iodothyronine deiodinase D3leading to rapid degradation of thyroid hormones and consumptive hypothyroidism.

  • We herein present a case in which we used liothyronine therapy for multifocal hepatic hemangiomas in a Japanese patient with low free T3 and normal free T4 levels.

  • New insight into the pathophysiology of severe hypothyroidism in an infant with multiple hepatic hemangiomas.

  • On this dose the child remained stable with normalization of thyroid function.

The dose should be increased gradually until a stabilising hemanfioma status is achieved. Abdominal computed tomography showed multifocal hemangiomas in both lobes of the liver. Thyroxine doses were tapered and finally stopped at the age of 21 months. The association of consumptive hypothyroidism secondary to hepatic hemangioma and severe heart failure in infancy.

Your documents are now available to view. At 4 months of age, abdominal US showed a reduction in the size of the hepatic hemangiomas. J Clin Endocrinol Metab 81 : — However, our patient did not demonstrate any of the above complications and rather showed resolution of cardiac failure.

Conclusions Neonatal screening for consumptive hypothyroidism hemangioma of liver hypothyroidism is usually negative in cases of IHH, as seen in our case. Supplementary concepts Hemangiomatosis, Disseminated. Consumptive hypothyroidism is a complication of infantile hepatic hemangioma IHH caused by increased expression of type-3 deiodinase enzyme in the tumor tissue. Case presentation A 4-month-old boy presented with abdominal distention. Abstract There have been reports of the use of levothyroxine or levothyroxine plus liothyronine for consumptive hypothyroidism caused by hepatic hemangiomas.

Articles in the same Issue

The severe hypothyroidism in this patient with hepatic hemangioma was comparable to the consumptive hypothyroidism described in earlier reports. However, our patient did not demonstrate any of the above complications and rather showed resolution of cardiac failure. Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases.

Therefore, thyroxine dose was further increased. In cases of hypothyroidism in the first year of life with consumptive hypothyroidism caused by hepatic haemangioma, aggressive L-thyroxine replacement is required with hypotyyroidism upper consumptive hypothyroidism hemangioma of liver. The patient remains in active follow-up. The TSH and free T3 levels normalized in this patient in less than 1 month. Normal ranges: TSH This case reiterates the importance of aggressive investigation and management of consumptive hypothyroidism in any infant diagnosed with IHH, particularly when there is systemic compromise. This case highlights the importance of early recognition and prompt management of consumptive hypothyroidism in patients with infantile hepatic hemangiomas.

A 2-month-old Japanese male was referred to our hospital because of hemanioma. Infantile hepatic hemangiomas IHHparticularly of hemangioma diffuse subtype can, in severe cases, be associated with hepatic and cardiac failure, compartment syndrome and consumptive hypothyroidism. This case reiterates the importance of aggressive investigation and management of consumptive hypothyroidism in any infant diagnosed with IHH, particularly when there is systemic compromise. The child was not found to have any cutaneous hemangiomas. The patient remains in active follow-up.

We report here similar pathophysiology in a young woman with subclinical primary hypothyroidism that was relieved by removal of a large D3-expressing tumor by liver transplantation. A yr-old female presented with abdominal fullness and constipation. Her weight at presentation was 4. All issues. Louis, MO were used at dilution.

Symptomatic infantile hepatic hemangioendothelioma successfully treated with steroid. Thyroid function studies in a patient with consumptive hypothyroidism secondary to a D3-expressing hepatic tumor. He had normal neonatal screening test results and no family history of thyroid disorders. Endocr J ;64 6 —

  • His fT4 level normalized by 3 months of age 1. They raised the possibility that some hemangiomas may secrete a TSH-like factor.

  • Publication types Case Reports. The dose should be increased gradually until a stabilising euthyroid status is achieved.

  • Published reports of patients with consumptive hypothyroidism. Term placental tissue is included as a positive control.

  • J Clin Endocrinol Metab 50 : —

  • A high level of the thyroid hormone inactivating enzyme type 3 iodothyronine deiodinase D3 was detected in her tumor, and the TSH of

  • Case Report Open Access.

It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. Table I. Case presentation A 4-month-old boy presented with abdominal distention. Published reports of patients with consumptive hypothyroidism. Intervention treatment of infantile hepatic hemangioendothelioma.

The resected liver weighed 4. Serial photography provided by the patient illustrated the onset of thyromegaly after the age of 17 yr. However, as in this case, patients with life-threatening conditions such as cardiac failure or severe hypothyroidism need prompt medical treatment. Harry P. Thyroid hormone replacement. A high level of the thyroid hormone inactivating enzyme type 3 iodothyronine deiodinase D3 was detected in her tumor, and the TSH of His blood and liver function test results also improved hemoglobin concentration,

Publication types

Hepatic hemangiomas: Subtype classification and development hemwngioma a clinical practice algorithm and registry. Thyroid Hormones. All authors agree to be accountable for all aspects related to the study. The severe hypothyroidism in this patient with hepatic hemangioma was comparable to the consumptive hypothyroidism described in earlier reports. Both synthetic peptides, commissioned from Neosystem S.

Detection of distant metastasis at the time of ablation in children with differentiated thyroid cancer: the value of pre-ablation stimulated thyroglobulin. The child had been born at term to a primigravida mother with a birth-weight of 2. Journal of Pediatric Endocrinology and Metabolism, Vol. Published online May 11,

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Epithelioid hemangioendothelioma: a vascular tumor often mistaken for a carcinoma. Related citations. Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. Advanced Search. Treatment was well tolerated without documented adverse effects.

By the age of 8 months, the TSH concentration was decreased to normal levels; the L-thyroxine dose was gradually reduced and finally discontinued at the age of 12 months. An abdominal ultrasound revealed multiple hypoechoic lesions in the liver. Abstract There have been reports of the use of levothyroxine or levothyroxine plus liothyronine for consumptive hypothyroidism caused by hepatic hemangiomas. Imaging identified innumerable hepatic hemangiomas, consistent with diffuse infantile hepatic hemangiomatosis. Liothyronine could be tapered and stopped after 5 months.

Parents also complained of dullness, poor cry and abdominal distention. We also propose early initiation of treatment of hemangiomas with propranolol as the first line therapy to prevent growth retardation and intellectual loss. Disclosure: The authors have no potential conflicts of interest to disclose.

Multiple infantile hepatic hemangiomas leading to consumptive hypothyroidism successfully treated with propranolol: A case report. J Pediatr Surg. Figures Show all The patient was asymptomatic. Normal ranges: TSH Sign In.

TSH level was elevated, free T3 level was low, free T4 level was henangioma, and hypothyroidism due to hepatic hemangiomas was diagnosed. Her weight at presentation was 4. N Engl J Med. Abstract Background Infantile hepatic haemangiomas IHHs produce an excess of the thyroid hormone inactivating enzyme type-3 iodothyronine deiodinase D3leading to rapid degradation of thyroid hormones and consumptive hypothyroidism.

Subsequent consummptive this, thyroid function tests confirmed an associated but comparatively rare form of hypothyroidism, known as consumptive hypothyroidism. Combined therapy may be useful in challenging cases where there is high rate of consumption of thyroid hormones. We describe a child who presented with severe hypothyroidism secondary to consumption by an IHH.

  • Stromal components of the tumor and the surrounding hepatic parenchyma did not stain for D3 Fig. Epithelioid hemangioendothelioma of the liver: a clinicopathologic study of cases.

  • N Engl J Med.

  • Multiple infantile hepatic hemangiomas leading to consumptive hypothyroidism successfully treated with propranolol: A case report.

  • Kozakewich, Susan J. Posttransplant 7 months.

On follow-up until the hemangipma of two years the child remained euthyroid, with age appropriate developmental milestones, and normal liver appearance on ultrasound scans. Physical examination revealed pallor, depressed nasal bridge and macroglossia. Keywords: Liothyronine, Management, Type 3 deiodinase. Intractable cases need hepatic artery embolization, segmental resection or liver transplantation. Subsequent to this, thyroid function tests confirmed an associated but comparatively rare form of hypothyroidism, known as consumptive hypothyroidism.

However, steroids can have adverse effects and also increase the thyroid hormone requirement by inducing type-3 deiodinase activity and impair T4 to T3 conversion leading to further worsening of thyroid function. This case highlights the importance of early recognition and prompt management of consumptive hypothyroidism in patients with infantile hepatic hemangiomas. Publication types Case Reports. The child was not found to have any cutaneous hemangiomas. Contrast-enhanced CT scan showed these lesions to have early enhancement with persistence in delayed phase consistent with a diagnosis of IHH Fig. Publication types Case Reports. Email: preetid sgpgi.

As untreated or inadequately treated hypothyroidism in the first year hemanngioma life can have severe consequences, like impaired neurodevelopmental outcome, aggressive treat-ment of babies with consumptive hypothyroidism is mandated. Background Infantile hepatic haemangiomas IHHs produce an excess of the thyroid hormone inactivating enzyme type-3 iodothyronine deiodinase D3leading to rapid degradation of thyroid hormones and consumptive hypothyroidism. In addition to propranolol, liothyronine was started. There was no history of poor feeding, umbilical hernia or jaundice.

The TFTs were at normal reference levels. Combined therapy may be useful in challenging cases where there consumptive hypothyroidism hemangioma of liver high cosnumptive of consumption of thyroid hormones. Thyroxine doses were tapered and finally stopped at the age of 21 months. Imaging identified innumerable hepatic hemangiomas, consistent with diffuse infantile hepatic hemangiomatosis. Keywords: Consumptive hypothyroidism; Hemangioma; Liothyronine; Type 3 deiodinase. Repeat abdominal ultrasound and MRI revealed a reduction in the number and size of the haemangiomas.

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By the age of 8 months, the TSH concentration was decreased to normal levels; the L-thyroxine dose was gradually reduced and finally discontinued at the age of 12 months. We describe a child who presented with severe hypothyroidism secondary to consumption by an IHH. During this period the child also developed congestive cardiac failure, which was treated with digoxin and furosemide. As the child was requiring such high doses of LT4, oral liothyronine T3 preparation Bitiron was added at a dose of There have been reports of the use of levothyroxine or levothyroxine plus liothyronine for consumptive hypothyroidism caused by hepatic hemangiomas.

N Engl J Med. After 10 months of propranolol treatment, repeat CT imaging showed complete resolution of tumor and propranolol was stopped Fig. However, steroids can have adverse effects and also increase the thyroid hormone requirement by inducing type-3 deiodinase activity and impair T4 to T3 conversion leading to further worsening of thyroid function. Over the next 3 months, there was significant reduction in tumor size and in her thyroxine requirements. Abstract Consumptive hypothyroidism is a rare paraneoplastic syndrome characterized by excessive inactivation of the thyroid hormones due to increased type 3 iodothyronine deiodinase activity of tumors. Indian Pediatr ; 75 The TFTs were at normal reference levels.

Three groups have published off of additional affected children, describing in some patients supernormal requirements for exogenous thyroid hormone and the complete resolution of hypothyroidism after hemangioma involution 111 — Liver biopsy was performed and revealed a vascular tumor interpreted as a hepatic hemangioendothelioma. Front Endocrinol Lausanne ; Go to: Notes. J Clin Res Pediatr Endocrinol ;

During this period the child also developed congestive cardiac failure, connsumptive was treated with digoxin and furosemide. Endocr Rev 23 : 38 — Volume 31 Issue 7. Pediatrics ; 1 :e J Korean Med Sci. Hemangiomas are not routinely biopsied for clinical care, but certain clinical and laboratory features should raise the suspicion for consumptive hypothyroidism.

Occasional mitoses were observed. Severe hypothyroidism caused by type 3 iodothyronine deiodinase in infantile hemangiomas. Hypothyroifism therapy of propranolol, levothyroxine, and liothyronine was effective in a case of severe consumptive hypothyroidism associated with infantile hepatic hemangioma. The V max was 3-fold that of term placenta, the normal human tissue with the highest D3 activity Fig.

Epithelioid hemangioendothelioma of the liver: a clinicopathologic study of cases. Impact of a liber treatment program on adipocytokines, oxidative status, inflammatory cytokines and arterial stiffness in obese children and adolescents. Consumptive hypothyroidism is a rare form of hypothyroidism that was first reported in an infant with massive hepatic hemangiomas by Huang et al.

Clinical practice guideline for the management of infantile hemangiomas. Adrenergic beta-Antagonists. Notable on physical examination was a soft, diffusely enlarged, slightly tender thyroid without discrete nodules. Other causes of hypothyroidism should be excluded by obtaining a thorough medication and dietary history and by the measurement of thyroid antibodies. Placental miRp is associated with maternal insulin resistance in late pregnancy.

J Pediatr Surg. We describe a child who presented with severe hypothyroidism secondary to consumption by an IHH. Funding: None; Competing interest: None stated. After 10 months of propranolol treatment, repeat CT imaging showed complete resolution of tumor and propranolol was stopped Fig.

We describe a child who coonsumptive with severe hypothyroidism secondary to consumption by an IHH. TSH persisted to be high even on Abstract Consumptive hypothyroidism is a rare paraneoplastic syndrome characterized by excessive inactivation of the thyroid hormones due to increased type 3 iodothyronine deiodinase activity of tumors. As untreated or inadequately treated hypothyroidism in the first year of life can have severe consequences, like impaired neurodevelopmental outcome, aggressive treat-ment of babies with consumptive hypothyroidism is mandated. This case reiterates the importance of aggressive investigation and management of consumptive hypothyroidism in any infant diagnosed with IHH, particularly when there is systemic compromise.

  • J Clin Neonatol ; With medical treatment, he showed gradual improvements in clinical status and laboratory profile.

  • Following joint consultation with dermatology and endocrinology she was promptly treated with oral propranolol and levothyroxine, with subsequent improvement in her clinical parameters.

  • Endocr J ;64 6 —

  • Thyroid ultrasound showed a eutopicaly located gland and thyroid scan showed normal radionuclide uptake.

  • The present case required very high doses of levothyroxine to achieve a euthyroid status.

He also had respiratory acidosis pH, clnsumptive. Indian Pediatr ; 75 Front Endocrinol Lausanne ; Acquired hypothyroidism is one of the rare manifestation of this entity. Severe hypothyroidism caused by type 3 iodothyronine deiodinase in infantile hemangiomas. This clinical course confirms a diagnosis of consumptive hypothyroidism similar to that reported in infants with hepatic hemangiomas.

After 10 months of propranolol treatment, repeat CT imaging showed complete resolution of tumor and propranolol was stopped Consumptive hypothyroidism hemangioma of liver. Thyroid function tests should be performed at short intervals and the test results monitored for dose titration to avoid iatrogenic hyperthyroidism. Sitemap What's New Feedback Disclaimer. Since the original report of consumptive hypothyroidism due to high D3 expression in an infant with a large hepatic hemangioma, eight others with acquired hypothyroidism during the proliferative phase of hemangioma growth have been reported to us personal communication. Because most patients do not show clinical symptoms and signs of hypothyroidism, screening for hypothyroidism is of utmost importance in patients with infantile hepatic hemangiomas.

Chest radiography showed cardiomegaly with bilateral pulmonary edema, and echocardiography suggested high-output cardiac failure with no intracardiac anomaly ejection fraction, Email alerts Article activity alert. Propranolol as a first-line treatment for diffuse infantile hepatic hemangioendothelioma.

  • Received November 28, ; Accepted April 28, As the child was requiring such high doses of LT4, oral liothyronine T3 preparation Bitiron was added at a dose of

  • Consumptive hypothyroidism is a rare paraneoplastic syndrome characterized by excessive inactivation of the thyroid hormones due to increased consuptive 3 iodothyronine deiodinase activity of tumors. Propranolol should possibly be offered as first line therapy to infants with diffuse IHH, especially those with hypothyroidism, as rapid normalization of thyroid function is highly desirable to ensure normal neurodevelopment.

  • Hypothyroidism generally appears during a period of tumor growth and resolves after tumor involution or resection. Conclusions Neonatal screening for congenital hypothyroidism is usually negative in cases of IHH, as seen in our case.

Both synthetic peptides, commissioned from Neosystem S. Imaging studies confirmed pf markedly enlarged liver measuring 27 cm in length. Liver biopsy was performed and revealed a vascular tumor interpreted as a hepatic hemangioendothelioma. Search ADS. Posttransplant 7 months. Notable on physical examination was a soft, diffusely enlarged, slightly tender thyroid without discrete nodules.

There was no history of poor feeding, umbilical hernia or jaundice. Funding: None; Competing interest: None stated. Keywords: consumptive hypothyroidism; Hemangioma; type 3 iodothyronine deiodinase, propranolol. Keywords: Liothyronine, Management, Type 3 deiodinase. Second line therapy consisted of vincristine, interferon and cyclophosphamide [2].

The patient remains in active follow-up. The TSH and free T3 levels normalized in this patient in less than 1 month. Infantile hepatic hemangiomas IHHparticularly of the diffuse subtype can, in severe cases, be associated with hepatic and cardiac failure, compartment syndrome and consumptive hypothyroidism.

  • However, steroids can have adverse effects and also increase the thyroid hormone requirement by inducing type-3 deiodinase activity and impair T4 to T3 conversion leading to further worsening of thyroid function. Hypothyroidism due to hepatic hemangioendothelioma: A case report.

  • J Paediatr Child Health. The present case required very high doses of levothyroxine to achieve a euthyroid status.

  • Oxford Academic. Huang SA.

  • The intervascular stroma was characterized by myofibroblasts and abundant intercellular mucin.

  • There was no family history of thyroid disease.

We report here similar pathophysiology in a young woman with subclinical primary hypothyroidism that was relieved by removal of a large D3-expressing tumor by liver transplantation. J Paediatr Child Health. The tumoral growth was diffusely infiltrative with entrapment of normal hepatic tissue. Thyroid US showed a eutopic gland of normal size and echogenicity. Combination therapy of propranolol, levothyroxine, and liothyronine was effective in a case of severe consumptive hypothyroidism associated with infantile hepatic hemangioma. Bariatric interventions in craniopharyngioma patients — Best choice or last option for treatment of hypothalamic obesity? Download all slides.

Her abdomen was distended and liver palpable consumptive hypothyroidism hemangioma of liver cm below the costal margin. We report an interesting case of a female infant who presented with systemic compromise, in the absence of large or obvious cutaneous infantile hemangiomas. Infantile hepatic hemangioma IHH -related consumptive hypothyroidism is rare and occurs as a result of excess thyroid hormone inactivating enzyme, type-3 iodothyronine deiodinase. An abdominal ultrasound revealed multiple hypoechoic lesions in the liver. Imaging identified innumerable hepatic hemangiomas, consistent with diffuse infantile hepatic hemangiomatosis.

Turk Pediatri Ars. TSH persisted to be high even on Keywords: consumptive hypothyroidism; Hemangioma; type 3 iodothyronine deiodinase, propranolol.

Case presentation A 4-month-old boy presented with abdominal distention. Thyroxine doses were tapered and finally stopped hypothyroudism the age of 21 months. A 2-month-old Japanese male was referred to our hospital because of jaundice. The liothyronine dose was gradually reduced with regression of the hemangiomas, and liothyronine administration was discontinued at the age of 5 months.

Oral prednisolone was gradually tapered off over 3 months, while propranolol was continued. Occasional mitoses were observed. This case highlights the importance of early recognition hgpothyroidism prompt management of consumptive hypothyroidism in patients with infantile hepatic hemangiomas. Definitive therapy for the hemangioma and reduction in tumor burden leads to resolution of hypothyroidism. On this dose the child remained stable with normalization of thyroid function. The images are published under agreement of the patient's parents. Hepatic hemangiomas: Subtype classification and development of a clinical practice algorithm and registry.

We also propose early initiation of treatment of hemangiomas with propranolol as the first line therapy to prevent growth retardation and intellectual loss. Turk Pediatri Ars. Receive exclusive offers and updates from Oxford Academic. Fish, David M.

Related citations. Contributors: All authors were involved in case-management and manuscript preparation, and approved the final version of manuscript. The L-thyroxine replacement dose in patients with consumptive hypothyroidism is inappropriately higher than that in congenital hypothyroidism. Imaging studies confirmed a markedly enlarged liver measuring 27 cm in length.

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Hypotthyroidism Engl J Med : — Spontaneous regression of severe acquired infantile hypothyroidism associated with multiple liver hemangiomas. He had normal neonatal screening test results and no family history of thyroid disorders. Google Scholar. Cite Cite Stephen A. Only minimal cold intolerance was reported on review of systems, and the patient was otherwise well. The patient was successfully treated with propranolol, prednisolone, and levothyroxine, and he showed normal thyroid function at 3 months of age and normal neurodevelopment at 9 months of age.

  • Term placental tissue from a woman with no known medical problems was used as a control. Cancer 78 : —

  • Conclusions Neonatal screening for congenital hypothyroidism is usually negative in cases of IHH, as seen in our case. By the age of 8 months, the TSH concentration was decreased to normal levels; the L-thyroxine dose was gradually reduced and finally discontinued at the age of 12 months.

  • Multiple infantile hepatic hemangiomas leading to consumptive hypothyroidism successfully treated with propranolol: A case report.

  • In summary, clinicians should maintain a high index of suspicion for consumptive hypothyroidism in both children and adults with large vascular tumors.

Keywords: consumptive hypothyroidism; infantile hepatic haemangioma; type 3 iodothyronine deiodinase. Case presentation A 4-month-old boy presented with abdominal distention. There was no history of poor feeding, umbilical hernia or jaundice. There was no bradycardia or hypotension during therapy. The patient remains in active follow-up. J Paediatr Child Health. Physical examination revealed pallor, depressed nasal bridge and macroglossia.

Abstract Consumptive hypothyroidism is a rare consumptive hypothyroidism hemangioma of liver syndrome characterized by excessive inactivation of the thyroid hormones due to increased type 3 iodothyronine deiodinase activity of tumors. Hypothyroidim, even after two weeks, TSH remained high. We describe a child who presented with severe hypothyroidism secondary to consumption by an IHH. Publication types Case Reports. This is the first report demonstrating the use of liothyronine with propranolol for treatment of this type of consumptive hypothyroidism. Spectrum of hepatic hemangiomas: management and outcome.

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