Rapid resolution of consumptive hypothyroidism in a child with hepatic hemangioendothelioma following liver transplantation.
We report a unique case of a 3-mo-old female with consumptive hypothyroidism and liver hemangioendothelioma who required pharmacological doses of thyroid hormones and was cured following liver transplantation. Liver hemangioendotheliomas are capable of producing an excess of the thyroid hormone inactivating enzyme, type-3 iodothyronine deiodinase. The increased tumoral enzyme activity leads to rapid degradation of thyroid hormones, resulting in consumptive hypothyroidism. Review of similar cases indicated variable outcomes. We focus on our patient's clinical course and describe in detail the thyroid hormone replacement therapy and a unique outcome of this rare type of hypothyroidism. This first example of a prompt and complete resolution of consumptive hypothyroidism in an infant after liver transplantation confirms the concept and the reversibility of consumptive hypothyroidism and provides novel insights into the rapidity of response of the infant's hypothalamic-pituitary-thyroid axis to thyroid hormone replacement.
Balazs
Andrea E
AE
Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
Athanassaki
Ioanna
I
Gunn
Sheila K
SK
Tatevian
Nina
N
Huang
Stephen A
SA
Haymond
Morey W
MW
Karaviti
Lefkothea P
LP
D005260:Female; D006390:Hemangioendothelioma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007037:Hypothyroidism / Q000503:physiopathology*; D007223:Infant; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000097:blood / Q000627:therapeutic use
D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine