Çocukluk Çağında Karaciğer Hemanjiyomu Tanısıyla Takip Edilen Hastaların Tiroit Fonksiyon Testlerinin Değerlendirilmesi

Year 2023, Volume: 11 Issue: 2, 34 - 37, 31.07.2023

Evrim Kılıçlı Yavuz Köksal

https://doi.org/10.21765/pprjournal.1255408

Abstract

Amaç: Bu çalışmanın amacı hemanjiyom tanısı alan hastalarda tiroit fonksiyon testlerinin değerlendirilmesidir.

Gereç ve Yöntemler: Ekim 2010-Ekim 2022 yılları arasında hemanjiyom tanısı ile takibe alınan ve tanı anında tiroit fonksiyon testleri bakılmış olan 20 hastanın dosyaları retrospektif olarak incelendi. Hastaların demografik ve klinik özellikleri ile görüntüleme ve laboratuvar bilgileri not edildi.

Bulgular: Çalışmaya dahil edilen 20 hastanın 13’ü (%65’i) kız ve 7’si (%35’i) erkekti. Hastaların yaşı 4 gün ile 16,5 yıl arasında değişiyordu (ortanca, 20 ay). 10 hasta (%50) infanttı. 3 hasta (%15) preterm iken, 17 hasta (%85) termdi. Karaciğer hemanjiyomu 17 hastada tesadüfen bulunurken (%85), 2 hastada (%10) karın ağrısı ve 1 hastada (%5) ise antenatal tanı ile saptanmıştı. Karaciğerdeki hemanjiyom boyutları 4 ile 50 mm arasında değişiyordu (ortanca 10 mm). Hastaların tiroit fonksiyonları incelendiğinde 19 hastada (%95) tiroit fonksiyonları normal iken 1 hastada (%5) subklinik hipotiroidi olduğu saptandı.

Sonuç: İnfantil hepatik hemanjiyoma bağlı hipotiroidizm için çalışmalar yetersiz olup hangi tip infantil hepatik hemanjiyomda hipotiroidinin görülme riskinin arttığı tam olarak belirlenene kadar takipte hipotiroidi gelişebileceği akılda tutulmalıdır.

Keywords

Çocukluk çağı, hemanjiyom, hipotiroidi

Evaluation of Thyroid Function Tests in Patients Followed Up with the Diagnosis of Liver Hemangioma in Childhood

Abstract

Objective: The aim of this study is to evaluate the thyroid function tests in patients diagnosed with hemangioma.

Materials and Methods: Between October 2010 - October 2022 ; the files of 20 patients who were followed up with the diagnosis of hemangioma and whose thyroid function tests were also checked at the time of diagnosis were retrospectively analyzed. Patients demographic and clinical characteristics, imagings and laboratory results were noted.

Results: Of the 20 patients included in the study; 13 (65%) were female and 7 (35%) were male. The age of the patients ranged from 4 days to 16.5 years (median, 20 months). 10 patients (50%) were infants. While 3 patients (15%) were preterm, 17 patients (85%) were term. Liver hemangioma was found incidentally in 17 patients (85%); 2 patient (10%) diagnosed with abdominal pain and antenatal diagnosis in 1 patient (5%). Hemangiomas in the liver ranged in size from 4 to 50 mm (median 10 mm). When the thyroid functions of the patients were examined; thyroid functions were normal in 19 patients (95%), and subclinical hypothyroidism was found in 1 patient (5%).

Conclusion: Studies for hypothyroidism due to infantile hepatic hemangioma are insufficient, but it should be kept in mind that hypothyroidism may develop in the follow-up until it is fully determined which type of infantile hepatic hemangioma has an increased risk of hypothyroidism.

Keywords

Childhood, hemangioma, hypothyroidism

References

• 1. Kilcline C, Frieden IJ. Infantile hemangiomas: how common are they? A systematic review of the medical literature. Pediatr Dermatol 2008;25:168-73.
• 2. Anderson KR, Schoch JJ, Lohse CM, Hand JL, Davis DM, Tollefson MMJJotAAoD. Increasing incidence of infantile hemangiomas (IH) over the past 35 years: Correlation with decreasing gestational age at birth and birth weight. 2016;74:120-6.
• 3. Ding Y, Zhang J-Z, Yu S-R, Xiang F, Kang X-JJWJoP. Risk factors for infantile hemangioma: a meta-analysis. 2020;16:377-84.
• 4. Drolet BA, Swanson EA, Frieden IJ, Group HIJTJop. Infantile hemangiomas: an emerging health issue linked to an increased rate of low birth weight infants. 2008;153:712-5. e1.
• 5. Ji Y, Chen S, Yang K, et al. Screening for infantile hepatic hemangioma in patients with cutaneous infantile hemangioma: A multicenter prospective study. J Am Acad Dermatol 2021;84:1378-84.
• 6. Hoeger PH, Harper JI, Baselga E, et al. Treatment of infantile haemangiomas: recommendations of a European expert group. Eur J Pediatr 2015;174:855-65.
• 7. Huang SA, Tu HM, Harney JW, et al. Severe hypothyroidism caused by type 3 iodothyronine deiodinase in infantile hemangiomas. N Engl J Med 2000;343:185-9.
• 8. Bauland CG, Lüning TH, Smit JM, Zeebregts CJ, Spauwen PHM. Untreated hemangiomas: growth pattern and residual lesions. Plast Reconstr Surg 2011;127:1643-8.
• 9. Krowchuk DP, Frieden IJ, Mancini AJ, et al. Clinical Practice Guideline for the Management of Infantile Hemangiomas. Pediatrics 2019;143.
• 10. Martin JM, Sanchez S, González V, Cordero P, Ramon D. Infantile hemangiomas with minimal or arrested growth: A retrospective case series. Pediatr Dermatol 2019;36:125-31.
• 11. Itinteang T, Tan ST, Guthrie S, et al. A placental chorionic villous mesenchymal core cellular origin for infantile haemangioma. J Clin Pathol 2011;64:870-4.
• 12. Tarim OF, Yordam N. Congenital hypothyroidism in Turkey: a retrospective evaluation of 1000 cases. Turk J Pediatr 1992;34:197-202.
• 13. Itinteang T, Marsh R, Davis PF, Tan ST. Angiotensin II causes cellular proliferation in infantile haemangioma via angiotensin II receptor 2 activation. J Clin Pathol 2015;68:346-50.
• 14. Kuroda T, Hoshino K, Nosaka S, Shiota Y, Nakazawa A, Takimoto T. Critical hepatic hemangioma in infants: recent nationwide survey in Japan. Pediatr Int 2014;56:304-8.
• 15. Simsek E, Demiral M, Gundoğdu E. Severe consumptive hypothyroidism caused by multiple infantile hepatic haemangiomas. J Pediatr Endocrinol Metab 2018;31:823-7.
• 16. Joshi K, Bolia R, Poddar U, Dabadgao P. Consumptive Hypothyroidism Due to Diffuse Hepatic Hemangiomas Treated With Propranolol Therapy. Indian Pediatr 2020;57:366-8.
• 17. Emir S, Ekici F, İkiz MA, Vidinlisan S. The association of consumptive hypothyroidism secondary to hepatic hemangioma and severe heart failure in infancy. Turk Pediatri Ars 2016;51:52-6.