Severe consumptive hypothyroidism in hepatic hemangioendothelioma A rare complication of a common clinical condition

Walther, Antonia; Haeberle, Beate; Kueppers, Julia; Lurz, Eberhard; Schmid, Irene; Schmidt, Heinrich und Dubinski, Ilja (2022): Severe consumptive hypothyroidism in hepatic hemangioendothelioma A rare complication of a common clinical condition. In: Journal of Pediatric Endocrinology & Metabolism, Bd. 35, Nr. 12: S. 1560-1564

Abstract

Objectives Consumptive hypothyroidism may occur in hepatic hemangioendothelioma. The altered expression of deiodinases inactivates peripheral thyroid hormones. As a result, serum levels of free triiodothyronine and free thyroxine are reduced to varying degrees. There are no established recommendations for the dosage of sirolimus for this particular indication. We describe for the first time the course of treatment with low-dose sirolimus. Case presentation We present a 5-week-old infant with hepatic hemangioendothelioma and severe consumptive hypothyroidism. Due to hepatic infiltration he showed signs of right heart strain. Therapy of hemangioendothelioma was initiated with propranolol and, in the absence of response, methylprednisolone was added. Treatment was continued with low-dose sirolimus (due to side effects) and propranolol. Hypothyroidism was managed with levothyroxine and liothyronine. Conclusions Consumptive hypothyroidism due to cutaneous hemangioma and hepatic hemangioendothelioma can be managed with propranolol and low-dose sirolimus. Treatment of severe hypothyroidism may require a combinational therapy by substitution of both T3 and T4.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0334-018X
• Sprache: Englisch