Multiple infantile hepatic hemangiomas leading to consumptive hypothyroidism successfully treated with propranolol: A...

Area of Science:

• Pediatric Endocrinology
• Vascular Biology
• Hepatology

Background:

• Hepatic hemangiomas are common benign liver tumors in infants.
• Acquired hypothyroidism is a rare complication of hepatic hemangiomas.
• Infant hypothyroidism can lead to developmental issues if untreated.

Observation:

• A 4-month-old infant with multiple hepatic hemangiomas developed acquired hypothyroidism resistant to treatment.
• The infant was born to a diabetic mother.
• Hepatic hemangiomas were suspected to increase type 3 deiodinase activity, converting thyroid hormones T4 to rT3 and T3 to T2.

Findings:

• Treatment of hepatic hemangiomas with propranolol led to tumor regression.
• The infant achieved euthyroidism after hemangioma treatment.
• This suggests a direct link between hepatic hemangiomas and acquired hypothyroidism via deiodinase activity.

Implications:

• Screening for hepatic hemangiomas is recommended for infants with congenital hypothyroidism unresponsive to thyroxine therapy.
• Early propranolol treatment for hepatic hemangiomas may prevent growth retardation and intellectual deficits.
• This case highlights the importance of considering rare causes of endocrine dysfunction in infants.