Diffi cult 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, Giovanna Weber

Research output: Contribution to journalArticle

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 fi rst case of consumptive hypothyroidism secondary to a large parotid hemangioma, highlighting the diffi culties 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 benefi t. Introduction of propranolol instead led to normalization of thyroid hormones along with a dramatic involution of the hemangioma.

Original languageEnglish
Pages (from-to)153-155
Number of pages3
JournalJournal of Pediatric Endocrinology and Metabolism
Volume25
Issue number1-2
DOIs
Publication statusPublished - Feb 2012

Keywords

  • Hypothyroidism
  • Infantile parotid hemangioma
  • Propranolol

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Pediatrics, Perinatology, and Child Health

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