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vol.76 número3Síndrome hipereosinofílico en un lactanteLa fundación del Hospital Infantil de México, ahora Hospital Infantil de México Federico Gómez índice de autoresíndice de assuntospesquisa de artigos
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Boletín médico del Hospital Infantil de México

versão impressa ISSN 1665-1146

Resumo

MIRANDA-LORA, América L. et al. Resolution of fatty liver disease after growth hormone replacement in a pediatric survivor of thyroid cancer. Bol. Med. Hosp. Infant. Mex. [online]. 2019, vol.76, n.3, pp.138-145. ISSN 1665-1146.  https://doi.org/10.24875/bmhim.18000114.

Background

A rare case of primary papillary thyroid cancer (PTC) and growth hormone (GH) deficiency in a pediatric patient is described. In addition, the patient developed fatty liver disease attributed to GH deficiency.

Case report

A 10-year-old male with a history of PTC with extension to the cervical nodes detected at 5 years of age was referred to the endocrinology consultation due to a low growth rate. On examination, GH deficiency was detected (height −3.51 standard deviations and low insulin-like growth factor-1 levels). This hormonal deficiency was not associated with thyroid cancer or treatment. Furthermore, elevated transaminases (~300 IU/ml), lipids, and fally liver disease by ultrasound were detected. These data suggested fatty liver disease, which was attributed to GH deficiency. Regardless of the risk of recurrence, somatotropin was administered due to liver dysfunction and very short stature of the patient. A considerable improvement in growth, transaminases, and lipid profile was observed. At present, at 14 years of age, resolution of hepatic steatosis and a considerable increase in his growth rate without recurrence of thyroid cancer 9 years after its diagnosis and 4 years after the initiation of GH treatment are confirmed.

Conclusions

GH therapy could be a good therapeutic option for pediatric cancer survivors to address impaired growth and fatty liver disease. However, additional medical evidence based on clinical trials is necessary to determine the benefits.

Palavras-chave : liver disease; Thyroid cancer; Growth hormone deficiency; Children.

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