open access

Ahead of print
Clinical vignette
Published online: 2021-05-31
Submitted: 2021-03-24
Accepted: 2021-05-06
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Cardiac dysfunction associated with consumptive hypothyroidism in a case of hepatic hemangioma: case report

Zhichao Zheng, Youli Li, Liying Wang, chengjun Dai, Jieqi Qian, Chaoban Wang, Xiaoou Shan
DOI: 10.5603/EP.a2021.0054
·
Pubmed: 34057192

open access

Ahead of print
Clinical Vignette
Published online: 2021-05-31
Submitted: 2021-03-24
Accepted: 2021-05-06

Abstract

Background: Infantile hepatic hemangiomas (IHHs) are the most common liver tumor in infancy. And they have proved to lead to cardiac insufficiency and consumptive hypothyroidism. Case presentation: A two-month-old girl had two purple skin lesions. An abdominal ultrasound and MRI showed multiple hypoechoic lesions in the liver. Her TSH level was over 150.00 μIU/mL and Thyroglobulin (TG) was over 500 ng/ml. She was diagnosed with hypothyroidism and IHHs. The levothyroxine was started at 50 μg/d for hypothyroidism and propranolol was started at 0.5 mg/kg/d for IHHs. But she suffered cardiac insufficiency when her thyroid function was still abnormal. Propranolol was stopped and the levothyroxine was increased to 100 μg/d as a treatment. Two weeks later, The baby’s cardiac insufficiency improved. Conclusion: Consumptive hypothyroidism can cause cardiac insufficiency. A normal thyroid function is important for patients with IHHs, especially those with heart failure. The dosage of propranolol should be increased more slowly. High TG levels can help to distinguish consumptive hypothyroidism from congenital hypothyroidism.

Abstract

Background: Infantile hepatic hemangiomas (IHHs) are the most common liver tumor in infancy. And they have proved to lead to cardiac insufficiency and consumptive hypothyroidism. Case presentation: A two-month-old girl had two purple skin lesions. An abdominal ultrasound and MRI showed multiple hypoechoic lesions in the liver. Her TSH level was over 150.00 μIU/mL and Thyroglobulin (TG) was over 500 ng/ml. She was diagnosed with hypothyroidism and IHHs. The levothyroxine was started at 50 μg/d for hypothyroidism and propranolol was started at 0.5 mg/kg/d for IHHs. But she suffered cardiac insufficiency when her thyroid function was still abnormal. Propranolol was stopped and the levothyroxine was increased to 100 μg/d as a treatment. Two weeks later, The baby’s cardiac insufficiency improved. Conclusion: Consumptive hypothyroidism can cause cardiac insufficiency. A normal thyroid function is important for patients with IHHs, especially those with heart failure. The dosage of propranolol should be increased more slowly. High TG levels can help to distinguish consumptive hypothyroidism from congenital hypothyroidism.

Get Citation

Keywords

hepatic hemangioma, consumptive hypothyroidism, cardiac dysfunction

About this article
Title

Cardiac dysfunction associated with consumptive hypothyroidism in a case of hepatic hemangioma: case report

Journal

Endokrynologia Polska

Issue

Ahead of print

Article type

Clinical vignette

Published online

2021-05-31

DOI

10.5603/EP.a2021.0054

Pubmed

34057192

Keywords

hepatic hemangioma
consumptive hypothyroidism
cardiac dysfunction

Authors

Zhichao Zheng
Youli Li
Liying Wang
chengjun Dai
Jieqi Qian
Chaoban Wang
Xiaoou Shan

References (5)
  1. Rialon KL, Murillo R, Fevurly RD, et al. Risk factors for mortality in patients with multifocal and diffuse hepatic hemangiomas. J Pediatr Surg. 2015; 50(5): 837–841.
  2. Zaki SA, Dolas A. Refractory cardiogenic shock in an infant with congenital hypothyroidism. Indian J Crit Care Med. 2012; 16(3): 151–153.
  3. Bianco AC, Salvatore D, Gereben B, et al. Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases. Endocr Rev. 2002; 23(1): 38–89.
  4. Huang SA, Tu HM, Harney JW, et al. Severe hypothyroidism caused by type 3 iodothyronine deiodinase in infantile hemangiomas. N Engl J Med. 2000; 343(3): 185–189.
  5. Spencer CA, Wang CC. Thyroglobulin measurement. Techniques, clinical benefits, and pitfalls. Endocrinol Metab Clin North Am. 1995; 24(4): 841–863.

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