Difficult treatment of consumptive hypothyroidism in a child with massive parotid hemangioma
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Maria Cristina Vigone
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.
©2012 by Walter de Gruyter Berlin Boston
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Artikel in diesem Heft
- Editorial
- 10.1515/jpem-2012-0999
- Reviews
- Sertoli cell markers in the diagnosis of paediatric male hypogonadism
- Congenital hypothyroidism
- Images in Pediatric Endocrinology
- Autoimmune thyroid disease and allergic contact dermatitis: two immune-related pathologies in the same patient
- Metformin use in children with obesity and normal glucose tolerance – effects on cardiovascular markers and intrahepatic fat
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- Newer Doppler echocardiography techniques in assessment of heart function in obese patients
- Effects of a multicomponent wellness intervention on dyslipidemia among overweight adolescents
- The relation of vitamin D deficiency with puberty and insulin resistance in obese children and adolescents
- Ultrasonographic description of brain cortex and cingulate sulcus development in Mexican neonates and infants with congenital hypothyroidism
- GH deficiency during the transition period: clinical characteristics before and after GH replacement therapy in two different subgroups of patients
- Therapy strategies in vitamin D deficiency with or without rickets: efficiency of low-dose stoss therapy
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- Changes in carotid artery sonogram in premature adrenarche
- Patient Reports
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- Encephalopathy and sinustachycardia in childhood a possible differential diagnosis
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- A case of early-onset obesity, hypocortisolism, and skin pigmentation problem due to a novel homozygous mutation in the proopiomelanocortin (POMC) gene in an Indian boy
- Hepatic dysfunction is associated with vitamin D deficiency and poor glycemic control in diabetes mellitus
- Severe hypercalcemia without hypercalciuria in a previously healthy infant
- Mucolipidosis type II (I-cell disease) masquerading as rickets: two case reports and review of literature
- A case of diabetes mellitus associated with Rett Syndrome
- Peripubertal hypoglycemia – an unusual cause
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- Meetings
- Meetings Calendar
- Prelims
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