关键词: 婴幼儿肝血管瘤； 消耗性甲状腺功能减退症； 早期诊断； 治疗

Abstract: Objective To investigate the diagnosis and treatment of infantile hepatic hemangioma (IHH). Methods The clinical data of an infant with hepatic multiple focal hemangioma presenting with recurrent anemia and congenital hypothyroidism was retrospectively analyzed and the related literatures were reviewed. Results Congenital hypothyroidism was diagnosed 2 days after birth in an infant baby girl, and oral levothyroxine treatment showed poor efficacy. At the age of 2 months, the hemoglobin was 68 g/L, and the reticulocyte count increased, and the blood routine examination suggested normal cellular anemia. Total bilirubin, unconjugated bilirubin, bile acid, glycholic acid and γ-glutamyl transpeptidase increased significantly, thyroid stimulating hormone increased significantly, and free T 3 decreased significantly. Ultrasonography showed that there were several hypoechoic masses scattered in the liver parenchyma, the largest one was located in the right lobe of liver with a size of about 8 . 9 cm×5 . 3 cm. Abdominal CT showed a significantly enlarged liver with a size of 117 mm×145 mm× 90 mm. In the liver parenchyma, there were abnormal enhancements of round shape, presenting multiple cystic lesions of varying sizes and slightly high-density septa surrounding the cystic lesions. The child was diagnosed with hepatic hemangioma and was given propranolol plus levothyroxine treatment. After 6 months of followup, abdominal ultrasonography showed that the number and size of hepatic hemangiomas had been reduced by half, and the levels of liver enzymes and bile acids had dropped to normal ranges. Therefore, the dosage of levothyroxine was gradually reduced, and the thyroid function of the child returned to normal. At present, the growth and development of the child are similar to those of normal age. Conclusions Infantile hepatic hemangioma can lead to serious complications, timely diagnosis and treatment can significantly improve the prognosis.

Key words: infantile hepatic hemangioma; consumptive hypothyroidism; early diagnosis; treatment