Cardiac dysfunction associated with consumptive hypothyroidism in a case of hepatic hemangioma: case report.

Background Infantile hepatic hemangiomas (IHHs) are the most common liver tumor in infancy. And they have proved to lead to cardiac insufficiency and consumptive hypothyroidism. Case presentation A two-month-old girl had two purple skin lesions. An abdominal ultrasound and MRI showed multiple hypoechoic lesions in the liver. Her TSH level was over 150.00 μIU/mL and Thyroglobulin (TG) was over 500 ng/ml. She was diagnosed with hypothyroidism and IHHs. The levothyroxine was started at 50 μg/d for hypothyroidism and propranolol was started at 0.5 mg/kg/d for IHHs. But she suffered cardiac insufficiency when her thyroid function was still abnormal. Propranolol was stopped and the levothyroxine was increased to 100 μg/d as a treatment. Two weeks later, The baby's cardiac insufficiency improved. Conclusion Consumptive hypothyroidism can cause cardiac insufficiency. A normal thyroid function is important for patients with IHHs, especially those with heart failure. The dosage of propranolol should be increased more slowly. High TG levels can help to distinguish consumptive hypothyroidism from congenital hypothyroidism.