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Annals of Clinical & Laboratory Science 37:280-284 (2007)
© 2007 Association of Clinical Scientists

Case Report

Rapid Resolution of Consumptive Hypothyroidism in a Child with Hepatic Hemangioendothelioma Following Liver Transplantation

Andrea E. Balazs1, Ioanna Athanassaki1, Sheila K. Gunn1, Nina Tatevian1, Stephen A. Huang2, Morey W. Haymond1 and Lefkothea P. Karaviti1
1 Division of Pediatric Endocrinology and Metaboolism, and Department of Pediatric Pathology of Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas; 2 Division of Endocrinology, Children’s Hospital Boston, Harvard Medical School, Boston, Massachusetts

Address correspondence to Morey W. Haymond, M.D., Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA; tel 713 798 6776; fax 713 798 7119, e-mail mhaymond{at}bcm.tmc.edu.

We report a unique case of a 3-mo-old female with consumptive hypothyroidism and liver hemangioendothelioma who required pharmacological doses of thyroid hormones and was cured following liver transplantation. Liver hemangioendotheliomas are capable of producing an excess of the thyroid hormone inactivating enzyme, type-3 iodothyronine deiodinase. The increased tumoral enzyme activity leads to rapid degradation of thyroid hormones, resulting in consumptive hypothyroidism. Review of similar cases indicated variable outcomes. We focus on our patient’s clinical course and describe in detail the thyroid hormone replacement therapy and a unique outcome of this rare type of hypothyroidism. This first example of a prompt and complete resolution of consumptive hypothyroidism in an infant after liver transplantation confirms the concept and the reversibility of consumptive hypothyroidism and provides novel insights into the rapidity of response of the infant’s hypothalamic-pituitary-thyroid axis to thyroid hormone replacement.

Keywords: liver hemangioendothelioma, consumptive hypothyroidism, liver transplantation






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