Consumptive hypothyroidism complicating infantile hepatic hemangioma successfully treated with propranolol: a case report and literature review

Abstract Background Consumptive hypothyroidism (CH) is a rare paraneoplastic syndrome, caused by the overexpression in vascular tumors of type 3 deiodinase (D3), converting thyroid hormones into inactive metabolites. Case presentation We report the case of a 2-months-old male infant with diffuse inf...

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Main Authors: Irene Bettini, Giulia Poletti, Alessandro Rocca, Valeria Di Natale, Monia Gennari, Marcello Lanari, Andrea Pession, Alessandra Cassio
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Italian Journal of Pediatrics
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Online Access:https://doi.org/10.1186/s13052-025-02020-9
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author Irene Bettini
Giulia Poletti
Alessandro Rocca
Valeria Di Natale
Monia Gennari
Marcello Lanari
Andrea Pession
Alessandra Cassio
author_facet Irene Bettini
Giulia Poletti
Alessandro Rocca
Valeria Di Natale
Monia Gennari
Marcello Lanari
Andrea Pession
Alessandra Cassio
author_sort Irene Bettini
collection DOAJ
description Abstract Background Consumptive hypothyroidism (CH) is a rare paraneoplastic syndrome, caused by the overexpression in vascular tumors of type 3 deiodinase (D3), converting thyroid hormones into inactive metabolites. Case presentation We report the case of a 2-months-old male infant with diffuse infantile hepatic hemangioma (IHH). Thyroid function screening detected a CH. The patient was promptly treated with propranolol: after 2 weeks, a marked reduction in tumour size was observed and thyroid function was restored. No hormone replacement therapy was required. We then performed a literature review on PubMed/Medline: based on the title and abstract, we extracted 64 cases of CH secondary to IHH published between 2000 and 2023. 59.37% patients received propranolol, either alone (52.63%) or in combination with other treatments. 18.75% patients required surgical treatment or liver transplant. LT4 was administered in 92.85% of the patients. Patients who received propranolol required a lower dosage of LT4 than patients who received other treatments. Conclusions Thyroid function should be evaluated in all children with IHH to rule out CH. Early recognition of IHH and CH and prompt therapy with propranolol can effectively treat IHH and the subsequent hypothyroidism, sometimes even without the need of hormone replacement therapy.
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spelling doaj-art-d6faa104e8f64d64adb5224e68fba3252025-08-20T03:14:46ZengBMCItalian Journal of Pediatrics1824-72882025-06-015111910.1186/s13052-025-02020-9Consumptive hypothyroidism complicating infantile hepatic hemangioma successfully treated with propranolol: a case report and literature reviewIrene Bettini0Giulia Poletti1Alessandro Rocca2Valeria Di Natale3Monia Gennari4Marcello Lanari5Andrea Pession6Alessandra Cassio7Specialty School of Pediatrics, Alma Mater Studiorum, University of BolognaSpecialty School of Pediatrics, Alma Mater Studiorum, University of BolognaPediatric Emergency Unit, IRCCS, Azienda Ospedaliero-Universitaria di BolognaPediatric Unit, IRCCS, Azienda Ospedaliero-Universitaria di BolognaPediatric Emergency Unit, IRCCS, Azienda Ospedaliero-Universitaria di BolognaPediatric Emergency Unit, IRCCS, Azienda Ospedaliero-Universitaria di BolognaPediatric Unit, IRCCS, Azienda Ospedaliero-Universitaria di BolognaPediatric Unit, IRCCS, Azienda Ospedaliero-Universitaria di BolognaAbstract Background Consumptive hypothyroidism (CH) is a rare paraneoplastic syndrome, caused by the overexpression in vascular tumors of type 3 deiodinase (D3), converting thyroid hormones into inactive metabolites. Case presentation We report the case of a 2-months-old male infant with diffuse infantile hepatic hemangioma (IHH). Thyroid function screening detected a CH. The patient was promptly treated with propranolol: after 2 weeks, a marked reduction in tumour size was observed and thyroid function was restored. No hormone replacement therapy was required. We then performed a literature review on PubMed/Medline: based on the title and abstract, we extracted 64 cases of CH secondary to IHH published between 2000 and 2023. 59.37% patients received propranolol, either alone (52.63%) or in combination with other treatments. 18.75% patients required surgical treatment or liver transplant. LT4 was administered in 92.85% of the patients. Patients who received propranolol required a lower dosage of LT4 than patients who received other treatments. Conclusions Thyroid function should be evaluated in all children with IHH to rule out CH. Early recognition of IHH and CH and prompt therapy with propranolol can effectively treat IHH and the subsequent hypothyroidism, sometimes even without the need of hormone replacement therapy.https://doi.org/10.1186/s13052-025-02020-9Case reportConsumptive hypothyroidismInfantile hepatic hemangiomaPropranololThyroid hormones
spellingShingle Irene Bettini
Giulia Poletti
Alessandro Rocca
Valeria Di Natale
Monia Gennari
Marcello Lanari
Andrea Pession
Alessandra Cassio
Consumptive hypothyroidism complicating infantile hepatic hemangioma successfully treated with propranolol: a case report and literature review
Italian Journal of Pediatrics
Case report
Consumptive hypothyroidism
Infantile hepatic hemangioma
Propranolol
Thyroid hormones
title Consumptive hypothyroidism complicating infantile hepatic hemangioma successfully treated with propranolol: a case report and literature review
title_full Consumptive hypothyroidism complicating infantile hepatic hemangioma successfully treated with propranolol: a case report and literature review
title_fullStr Consumptive hypothyroidism complicating infantile hepatic hemangioma successfully treated with propranolol: a case report and literature review
title_full_unstemmed Consumptive hypothyroidism complicating infantile hepatic hemangioma successfully treated with propranolol: a case report and literature review
title_short Consumptive hypothyroidism complicating infantile hepatic hemangioma successfully treated with propranolol: a case report and literature review
title_sort consumptive hypothyroidism complicating infantile hepatic hemangioma successfully treated with propranolol a case report and literature review
topic Case report
Consumptive hypothyroidism
Infantile hepatic hemangioma
Propranolol
Thyroid hormones
url https://doi.org/10.1186/s13052-025-02020-9
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