Efficacy of propranolol treatment in thyroid dysfunction associated with severe infantile hepatic hemangioma.
Infantile hepatic hemangioma can be associated to consumptive hypothyroidism due to overexpression of type 3 deiodinase in the endothelium of vascular tumor, which catalyzes the conversion of T4 to reverse T3 (rT3) and of T3 to T2, both of which are biologically inactive. Here, we report an infant with a massive biopsy-proven infantile hepatic hemangioma who developed thyroid dysfunction without a typical biochemical profile consistent with severe consumptive hypothyroidism, despite the large tumor burden. Our patient was treated with propranolol that rapidly resolved both hepatic hemangioma and thyroid dysfunction. We propose propranolol as a first-line therapy of thyroid dysfunction associated with infantile hepatic hemangioma, in order to avoid interference with neurological development caused by hypothyroidism in the first months of life.
Department of Pediatrics, 'Infermi' Hospital, Rimini, Italy. lucvirgo75 @ hotmail.com
Gianluca
G
Vergine
Alberto
A
Marsciani
Annalisa
A
Pedini
Silvia
S
Brocchi
Martino
M
Marsciani
Elena
E
Desiderio
Sara
S
Bertelli
Vico
V
Vecchi
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D005260:Female; D006391:Hemangioma / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy*; D011433:Propranolol / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013959:Thyroid Diseases / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D011433:Propranolol