Startseite Difficult treatment of consumptive hypothyroidism in a child with massive parotid hemangioma
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Difficult treatment of consumptive hypothyroidism in a child with massive parotid hemangioma

  • Maria Cristina Vigone , Francesca Cortinovis , Sarah Rabbiosi , Marianna Di Frenna , Arianna Passoni , Luca Persani , Giuseppe Chiumello , Carlo Gelmetti und Giovanna Weber EMAIL logo
Veröffentlicht/Copyright: 20. Dezember 2011

Abstract

Consumptive hypothyroidism is a rare condition related to massive infantile hemangiomas producing an excess of the thyroid-hormone-inactivating enzyme type 3 iodothyronine deiodinase. We report the first case of consumptive hypothyroidism secondary to a large parotid hemangioma, highlighting the difficulties in selecting an adequate therapeutic strategy. The affected child was initially referred to our center for congenital hypothyroidism with a hypoplastic thyroid gland. l-Thyroxine (l-T4) replacement therapy was started at seven days of life. In the following weeks, the hemangioma rapidly increased in volume and the child developed severe hypothyroidism refractory to high doses of l-T4 therapy. The concentration of reverse triiodothyronine was elevated, suggesting that the underlying cause was an excessive conversion of thyroid hormones by high type 3 iodothyronine deiodinase levels in the tumor. Corticosteroid treatment showed only partial benefit. Introduction of propranolol instead led to normalization of thyroid hormones along with a dramatic involution of the hemangioma.


Corresponding author: Giovanna Weber, Department of Pediatrics, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, via Olgettina, 60, 20132 Milan, Italy Phone: +39 22 6432624-3401, Fax: +39 22 6437346

Received: 2011-10-23
Accepted: 2011-11-16
Published Online: 2011-12-20
Published in Print: 2012-02-01

©2012 by Walter de Gruyter Berlin Boston

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