Perioperative considerations in a hypothyroid infant with hepatic haemangioma

Abstract

Hepatic haemangiomas in infants are rare. An infant with both a hepatic haemangioma and a severe hypothyroid condition, unresponsive to conventional thyroxine therapy, will be described. This case presented here is the perioperative management of a critically ill infant who had myocardial depression secondary to hypothyroidism and a hepatic haemangioma that required embolization. To our knowledge, this is the first published report describing intravenous triiodothyronine as a therapeutic modality to stabilize a hypothyroid infant prior to undergoing a general anaesthetic.

Consumptive hypothyroidism: a case report and review of the literature

“…3,11 In some of the previous cases, children required extremely high doses of T4, T3 or combined thyroid replacement therapy. 4,12,13 Doses ranging between 5 and 94 mg/kg/d have been reported. 8 (For comparison, in conventional hypothyroidism the thyroid replacement therapy dose that maintains euthyroid status in infants ranges from 5 to 10 mg/kg/d.)…”

“…11,12 This suggests that a search for HHE should be undertaken in infants with severe unexplained hypothyroidism.…”

Use of liothyronine without levothyroxine in the treatment of mild consumptive hypothyroidism caused by hepatic hemangiomas

“…Most studies on this type of consumptive hypothyroidism report the use of levothyroxine or levothyroxine plus liothyronine for treatment [1][2][3][4][5][6][7][8][9][10][11][12]14]; while 1 study reported the use of liothyronine plus prednisolone [13]. However, there is no report of using liothyronine plus propranolol for the treatment of consumptive hypothyroidism.…”

Two Different Anesthesia Management of a Patient with Congenital Hypothyroidism and Bilateral Nephrolithiasis

“…KH'de konjenital kalp hastalıklarının yüksek prevalansta gö-rülmesi nedeniyle bu hastalara rutin ekokardiyografi uygulanması gerektiği bildirilmektedir (4) . Ayrıca tiroid hormonunun aktif formu olan triiyodotironinin spesifik olarak miyokarda etki ettiği ve hem direkt hem de indirekt olarak kardiyak fonksiyonu etkilediği gösteril-miştir (5,6) . Bu literatür bilgileri doğrultusunda hastamı-za preoperatif ekokardiyografi uygulanmış ve herhangi bir kardiyak anomaliye rastlanmamıştır.…”