Diffuse hepatic hemangioma with single cutaneous hemangioma: an alerting occurrence

Tasseh, Faten Al; El-Khansa, Merna; Abd, O.; Khalek, Anoir Abdel; El-Rifai, Nahida

doi:10.1002/ccr3.963

Cited by 8 publications

(2 citation statements)

References 12 publications

(15 reference statements)

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“…The dose required varies on an individual basis; in this case there was a rapid and sustained response to a dose of 9.6 µg/kg levothyroxine once daily (equivalent to a total dose of 37.5 µg/day). Much higher doses have been reported in the literature, with Emir et al ( 19 ) reporting the use of levothyroxine 75 µg/day in a female infant with IHH and associated consumptive hypothyroidism, and most recently Al Tasseh et al ( 20 ) documenting a dose of levothyroxine 25 µg/kg/day in order to achieve a euthyroid state in a 3.5-month-old male with diffuse IHH.…”

Section: Discussionmentioning

confidence: 99%

Resolution of Consumptive Hypothyroidism Secondary to Infantile Hepatic Hemangiomatosis with a Combination of Propranolol and Levothyroxine

Campbell

Beckett

Abid

et al. 2018

Jcrpe

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Infantile hepatic hemangiomas (IHH), particularly of the diffuse subtype can, in severe cases, be associated with hepatic and cardiac failure, compartment syndrome and consumptive hypothyroidism. Early recognition and treatment of these pathologies is paramount in order to minimise the risk of long-term sequelae.We report an interesting case of a female infant who presented with systemic compromise, in the absence of large or obvious cutaneous infantile hemangiomas. Imaging identified innumerable hepatic hemangiomas, consistent with diffuse infantile hepatic hemangiomatosis. Subsequent to this, thyroid function tests confirmed an associated but comparatively rare form of hypothyroidism, known as consumptive hypothyroidism. Following joint consultation with dermatology and endocrinology she was promptly treated with oral propranolol and levothyroxine, with subsequent improvement in her clinical parameters.This case reiterates the importance of aggressive investigation and management of consumptive hypothyroidism in any infant diagnosed with IHH, particularly when there is systemic compromise. We advocate propranolol as a single first line treatment for IHH, supported by thyroid replacement when appropriate.

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Section: Discussionmentioning

confidence: 99%

Resolution of Consumptive Hypothyroidism Secondary to Infantile Hepatic Hemangiomatosis with a Combination of Propranolol and Levothyroxine

Campbell

Beckett

Abid

et al. 2018

Jcrpe

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show abstract

“…Iodothyronine deiodinase is highly expressed in hepatic hemangioma cells and inactivates both triiodothyronine and thyroxine (3). While the traditional treatment for IHH was systemic steroid or interferon administration, propranolol is the currently recommended treatment choice (4, 5). Here, we report the case of a 4-mo-old boy with severe IHH-mediated consumptive hypothyroidism that was improved by propranolol-containing combination therapy administration, and review previous cases that were treated with propranolol.…”

Section: Introductionmentioning

confidence: 99%

Combination therapy of propranolol, levothyroxine, and liothyronine was effective in a case of severe consumptive hypothyroidism associated with infantile hepatic hemangioma

Osada

Araki

Yamashita

et al. 2019

Clin Pediatr Endocrinol

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Abstract.Infantile hepatic hemangioma (IHH) can be accompanied by consumptive hypothyroidism. We report the case of a 4-mo-old boy who showed massive hepatomegaly, peripheral coldness, lethargy, and failure to thrive. An enhanced computed tomography scans demonstrated multiple hemangiomas in both lobes of the liver, and a thyroid function tests showed severe hypothyroidism: TSH 561.5 µIU/mL, free triiodothyronine (fT3) 1.0 pg/mL, and free thyroxine (fT4) < 0.7 ng/dL. IHH gradually regressed following propranolol treatment and fT4 increased to a low normal level (1.0 ng/dL) by high dose replacement of levothyroxine, while fT3 remained very low (< 1.0 pg/mL), even following high doses of levothyroxine; fT3 eventually normalized following the administration of liothyronine. We suggest that treatment strategies should be individualized based on thyroid function, and that the combination therapy of propranolol for anti-tumor treatment and levothyroxine and liothyronine for respective thyroid hormone replacement is effective, particularly in cases of severe consumptive hypothyroidism due to multiple IHHs.

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Clinical evaluation of transcatheter arterial embolization combined with propranolol orally treatment of infantile hepatic hemangioma

Wang

Song

et al. 2022

Pediatr Surg Int

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Diffuse hepatic hemangioma with single cutaneous hemangioma: an alerting occurrence

Cited by 8 publications

References 12 publications

Resolution of Consumptive Hypothyroidism Secondary to Infantile Hepatic Hemangiomatosis with a Combination of Propranolol and Levothyroxine

Resolution of Consumptive Hypothyroidism Secondary to Infantile Hepatic Hemangiomatosis with a Combination of Propranolol and Levothyroxine

Combination therapy of propranolol, levothyroxine, and liothyronine was effective in a case of severe consumptive hypothyroidism associated with infantile hepatic hemangioma

Clinical evaluation of transcatheter arterial embolization combined with propranolol orally treatment of infantile hepatic hemangioma

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