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Asymmetric septal hypertrophy and hypothyroidism in children
Insights
Hypothyroidism in children can cause asymmetric septal hypertrophy, a heart muscle thickening. This condition reversed in one child after L-thyroxine treatment, suggesting a link between thyroid hormone and cardiac structure.
Area of Science:
- Pediatric Cardiology
- Endocrinology
- Cardiovascular Pathology
Background:
- Hypothyroidism is a condition of insufficient thyroid hormone production.
- Cardiac involvement in pediatric hypothyroidism is recognized but less commonly studied.
- Asymmetric septal hypertrophy (ASH) is a specific pattern of heart muscle thickening.
Observation:
- Two pediatric cases of hypothyroidism presented with echocardiographic evidence of ASH.
- One infant case showed significant interventricular septum thickening at necropsy.
- Histological findings included muscle fiber vacuolation and hypertrophy.
Findings:
- ASH in hypothyroidism was observed in the youngest reported cases.
- In one child, ASH resolved after 18 months of L-thyroxine treatment.
- Myocardial function indices normalized concurrently with ASH resolution.
Implications:
- This study highlights a potential association between hypothyroidism and ASH in pediatric patients.
- Reversibility of ASH with treatment suggests a direct impact of thyroid hormones on cardiac remodeling.
- Further research is needed to elucidate the underlying mechanisms of ASH in hypothyroidism.
Abstract:
Any echocardiographic study of two children with hypothyroidism demonstrated the presence of asymmetric septal hypertrophy. One child died aged 11 months, and pronounced thickening of the interventricular septum was confirmed at necropsy. There was also hypertrophy of the left ventricular free wall. Histological examination showed only slight muscle fibre disarray, but there was striking vacuolation and hypertrophy of muscle fibres. In the second case, a child aged five years, the asymmetric septal hypertrophy disappeared after 18 months' treatment with L-thyroxine. Furthermore, other indices of myocardial function also returned to normal. The mechanism producing asymmetric septal hypertrophy in hypothyroidism is unknown. These are the youngest cases in which this association has been reported.