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PEDIATRICS Vol. 112 No. 6 December 2003, pp. 1424-1426

EXPERIENCE AND REASON

Spontaneous Regression of Severe Acquired Infantile Hypothyroidism Associated With Multiple Liver Hemangiomas

Daniel Konrad, MD*, Graham Ellis, PhD{ddagger} and Kusiel Perlman, MD*

* Division of Endocrinology
{ddagger} Department of Biochemistry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada

A 9-week-old infant presented with severe postnatal hypothyroidism. His hypothyroidism corrected only after his L-thyroxine dose was progressively increased to 28 µg/kg/d. At 6 months of age, multiple clinically asymptomatic hepatic hemangiomas were detected and support a diagnosis of consumptive hypothyroidism as a result of increased type 3 iodothyronine deiodinase activity in the hemangiomas. Coincident with the involution of the hemangiomas, the child’s hypothyroidism improved and L-thyroxin replacement could be stopped at the age of 3 years. Despite some degree of hypothyroidism for several weeks during infancy, his growth and development have been normal.

Key Words: type 3 iodothyronine deiodinase • L-thyroxine • reverse T3 • free T4

Abbreviations: D3, type 3 iodothyronine deiodinase • rT3, reverse T3 • TSH, thyroid-stimulating hormone • fT4, free T4

Received for publication Aug 14, 2002; Accepted Mar 11, 2003.


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