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Severe Hypothyroidism Caused by Type 3 Iodothyronine Deiodinase in Infantile Hemangiomas
Abstract
Hemangiomas are the most common tumors of infancy, with a prevalence of 5 to 10 percent among one-year-olds. They are characterized by rapid growth in the first year of life, followed by involution and gradual regression by adolescence.1,2 We recently treated a three-month-old infant with massive hepatic hemangiomas and primary hypothyroidism who needed very high doses of thyroid hormone to restore euthyroidism and normal thyrotropin secretion. This finding suggested that the rate of degradation of thyroid hormone was accelerated. We subsequently identified high levels of type 3 iodothyronine deiodinase activity in the hemangioma tissue. This selenoenzyme, normally present in . . .
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“In that patient, the high serum levels of rT3 (413 ng/mL), followed by the demonstration of high expression of deiodinase type 3 (D3) in hemangioma tissue, were crucial to the diagnosis.”
From Can Reverse T3 Assay Be Employed to Guide T4 vs. T4/T3 Therapy in Hypothyroidism? (2019) · cites this paper as [22]
In the citing paper
“Increased type 3 deiodinase activity in large hemangiomas can cause increased metabolic clearance of administered LT4 and, with that, necessitate a higher LT4 dose (120–122).”
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Metadata
- Authors
- Huang, S. A., Tu, H. M., Harney, J. W., Venihaki, M., Butte, A. J., Kozakewich, H. P. W., Fishman, S. J., & Larsen, P. R.
- Affiliations
- Boston Children's Hospital (US)
- Brigham and Women's Hospital (US)
- Children's Hospital (TN)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2000-07-20
- Volume
- 343
- Issue
- 3
- Pages
- 185-189
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2320158996
- Cited by
- 540
- References
- 27
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 12 · 2023: 5 · 2022: 17 · 2021: 30 · 2020: 22 · 2019: 27 · 2018: 22 · 2017: 32 · 2016: 28 · 2015: 20 · 2014: 31 · 2013: 23 · 2012: 26
- FWCI
- 10.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (DK 07699, R01DK044128, DK-44128, T32DK007529, T32DK007699, DK-07529)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Vascular Malformations and Hemangiomas
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Keywords
- type 3 iodothyronine deiodinase, infantile hemangioma, hepatic hemangioma, primary hypothyroidism, severe hypothyroidism, selenoenzymes, thyroid hormone replacement, thyrotropin secretion
- MeSH terms
- Hemangioma, Humans, Hypothyroidism, Infant, Iodide Peroxidase, Liver Neoplasms, Magnetic Resonance Imaging, Male, Neoplasms, Multiple Primary, Retrospective Studies, Thyrotropin
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