Consumptive Hypothyroidism Caused by Paraneoplastic Production of Type 3 Iodothyronine Deiodinase
Abstract
Consumptive hypothyroidism is characterized by excessive inactivation of thyroid hormone by type 3 iodothyronine deiodinase (D3). Previously this rare syndrome was described in association with massive hemangiomas in children and in a single case of a hemangioendothelioma in an adult. Here we report the first case of consumptive hypothyroidism from a nonvascular tumor in a patient who required supraphysiologic doses of levothyroxine prior to the resection of a large malignant solitary fibrous tumor. The tumor expressed D3 message, protein and exhibited functional D3 enzymatic activity. The clinical presentation of this patient expands the differential diagnosis of hypothyroidism, adds to the growing list of paraneoplastic syndromes that impact the endocrine system, and extends the spectrum of tumor types associated with consumptive hypothyroidism.
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Vascular tumors, fibroblastic tumors, and gastrointestinal stromal tumors may overexpress D3 and result in a need for increased LT4 dose.
“Vascular tumors (198), fibroblastic tumors (199), and gastrointestinal stromal tumors (200) may each overexpress D3 and result in a need for an increased dose of LT 4 .”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [199]
Cites
Atypical and Malignant Solitary Fibrous Tumors in Extrathoracic Locations
Vallat‐Decouvelaere, A., Dry, S., & Fletcher, C. D. �. (1998) · The American Journal of Surgical Pathology · doi:10.1097/00000478-199812000-00007 · Cited by 650 · see citing works
Severe hypothyroidism caused by type 3 iodothyronine deiodinase in infantile hemangiomas
Huang, S. A., Tu, H. M., Harney, J. W., Venihaki, M., Butte, A. J., Kozakewich, H. P. W., Fishman, S. J., & Larsen, P. R. (2000) · New England Journal of Medicine · doi:10.1056/nejm200007203430305 · Cited by 540 · see citing works
Self-citationHuang, S. A., Dorfman, D. M., Genest, D. R., Salvatore, D., & Larsen, P. R. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-021291 · Cited by 211 · see citing works
Self-citationHuang, S. A., Fish, S. A., Dorfman, D. M., Salvatore, D., Kozakewich, H. P., Mandel, S. J., & Larsen, P. R. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-020627 · Cited by 98 · see citing works
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Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Kim, B. W., Peeters, R. P., Rosenthal, M. S., et al. (2014) · Thyroid® · doi:10.1089/thy.2014.0028 · Cited by 1,928 · see citing works
“Vascular tumors (198), fibroblastic tumors (199), and gastrointestinal stromal tumors (200) may each overexpress D3 and result in a need for an increased dose of LT4.”
Cellular and Molecular Basis of Deiodinase-Regulated Thyroid Hormone Signaling1
Gereben, B., Zavacki, A. M., Ribich, S., Kim, B. W., Huang, S. A., Simonides, W. S., Zeöld, A., & Bianco, A. C. (2008) · Endocrine Reviews · doi:10.1210/er.2008-0019 · Cited by 891 · see citing works
Self-citationParadigms of dynamic control of thyroid hormone signaling
Bianco, A. C., Dumitrescu, A., Gereben, B., Ribeiro, M. O., Fonseca, T. L., Fernandes, G. W., & Bocco, B. M. L. C. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00275 · Cited by 293 · see citing works
Reawakened interest in type III iodothyronine deiodinase in critical illness and injury
Huang, S. A., & Bianco, A. C. (2008) · Nature Clinical Practice Endocrinology & Metabolism · doi:10.1038/ncpendmet0727 · Cited by 95 · see citing works
Self-citationThyroid Hormone Inactivation in Gastrointestinal Stromal Tumors
Maynard, M. A., Marino-Enriquez, A., Fletcher, J. A., Dorfman, D. M., Raut, C. P., Yassa, L., Guo, C., Wang, Y., Dorfman, C., Feldman, H. A., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1308893 · Cited by 70 · see citing works
Self-citationType 3 deiodinase and consumptive hypothyroidism: a common mechanism for a rare disease
Luongo, C., Trivisano, L., Alfano, F., & Salvatore, D. (2013) · Frontiers in Endocrinology · doi:10.3389/fendo.2013.00115 · Cited by 67 · see citing works
Regulation of Tissue Iodothyronine Deiodinase Activity in a Model of Prolonged Critical Illness
Debaveye, Y., Ellger, B., Mebis, L., Darras, V. M., & Van den Berghe, G. (2008) · Thyroid · doi:10.1089/thy.2007.0287 · Cited by 50 · see citing works
Consumptive Hypothyroidism Resulting from Hepatic Vascular Tumors in an Athyreotic Adult
Howard, D., La Rosa, F. G., Huang, S., Salvatore, D., Mulcahey, M., Sang-Lee, J., Wachs, M., & Klopper, J. P. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-2104 · Cited by 30 · see citing works
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- Authors
- Ruppe, M. D., Huang, S. A., & Jan de Beur, S. M.
- Affiliations
- Johns Hopkins University (US)
- Brigham and Women's Hospital (US)
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
- ORCID
- Huang, Stephen A.
- Venue
- Thyroid
- Publisher
- SAGE Publications
- Published
- 2005-12
- Volume
- 15
- Issue
- 12
- Pages
- 1369-1372
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- OpenAlex
- W2069456672
- Cited by
- 54
- References
- 4
- Citations by year
- 2025: 2 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 1 · 2016: 5 · 2015: 2 · 2014: 5 · 2013: 4 · 2012: 2
- FWCI
- 1.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Thyroid (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (DK60494, T32DK07751, T32DK007751, K08DK060494)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- type 3 iodothyronine deiodinase, paraneoplastic syndrome, solitary fibrous tumor, thyroid hormone inactivation, levothyroxine
- MeSH terms
- Humans, Hypothyroidism, Iodide Peroxidase, Male, Middle Aged, Paraneoplastic Syndromes, Thyroid Neoplasms
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