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Vascular tumours and malformation
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Cameron C Trenor III, Steven J Fishman, Arin K Greene
With the exception of secondary malignancies and splenic rupture, each of the options is a potential complication of infantile haemangiomas, though most are dependent on the size and location of the tumour. Infantile haemangiomas may leave residual fibrofatty tissue. Ulceration is common for lesions subject to incidental trauma (lips, nasal tip, perineum and hands), though may occur in any rapidly proliferating, large lesions. Hepatic haemangiomas include solitary, multifocal and diffuse tumours. Solitary lesions involute rapidly and rarely require intervention. Multifocal lesions may include shunting and present with high-output cardiac failure. Diffuse hepatic haemangiomas are associated with consumptive hypothyroidism due to expression of type III iodothyronine deiodinase. Because of the importance of developing binocular vision through infancy, periocular haemangiomas may require intervention (intralesional or systemic corticosteroids, possibly resection) to maximise visual field exposure. Submandibular (called ‘beard’ distribution) haemangiomas are associated with underlying subglottic haemangiomas that can compress the airway during the proliferative phase. Lumbosacral midline haemangiomas are associated with underlying spinal dysraphisms. Gastrointestinal bleeding with infantile haemangioma is uncommon, but could represent intestinal lesions or rarely corticosteroid-induced ulceration.
Hepatic tumors
Published in Prem Puri, Newborn Surgery, 2017
Benjamin A. Farber, William J. Hammond, Michael P. La Quaglia
Multifocal and diffuse HHs are true IHs both by histopathology and natural history. There is a spectrum of disease with multifocal HHs randomly distributed among otherwise normal liver parenchyma and diffuse HHs exhibiting near-total liver parenchyma replacement. The diagnosis is often made while screening for visceral hemangioma based upon finding of multiple cutaneous IHs. Massive hepatomegaly from multifocal HHs can result in abdominal compartment syndrome and respiratory failure. All HHs express type III iodothyronine deiodinase and can inactivate thyroid hormone giving rise to profound hypothyroidism, resulting in exacerbation of cardiac failure and cognitive delay.
Hepatic Tumors
Published in John F. Pohl, Christopher Jolley, Daniel Gelfond, Pediatric Gastroenterology, 2014
Rohit Gupta, Laura S. Finn, Karen F. Murray
Most IHH are diagnosed before the first year of life manifesting as an asymptomatic abdominal mass. Life-threatening complications include high output congestive heart failure (CHF) resulting from arteriovenous shunting of blood along with Kasabach–Meritt syndrome of coagulopathy due to platelet sequestration. Hypothyroidism, detected in patients with diffuse heman-giomas and in a subset with multi-focal lesions, is a result of increased activity of type 3 iodothyronine deiodinase produced directly from the tumor. Hypothyrodism in addition to the arteriovenous shunting can exacerbate the cardiac dysfunction. The majority of patients with multi-focal liver tumors have hemangiomas at other sites including skin, trachea, chest, adrenal glands, and the dura mater.
Reduced contextually induced muscle thermogenesis in rats with calorie restriction and lower aerobic fitness but not monogenic obesity
Published in Temperature, 2023
Ashley M. Shemery, Meredith Zendlo, Jesse Kowalski, Erin Gorrell, Scott Everett, Jacob G. Wagner, Ashley E. Davis, Lauren G. Koch, Steven L. Britton, Joram D. Mul, Colleen M. Novak
The suppressed muscle thermogenesis could stem from one or more of several potential mechanisms during food restriction. Lower leptin levels concomitant with fat loss impair the thermogenic response to cold exposure in mice [41]. Like muscle thermogenesis [10], brain control of brown adipose tissue (BAT) thermogenesis is regulated centrally and controlled by SNS outflow [42]. Human skeletal muscle shows biochemical adaptations to weight reduction, along with increased muscle work efficiency [43–45], and much of this is countered by leptin treatment [46,47]. In addition, recovery from weight loss alters iodothyronine deiodinase actions in muscle to favor lower T3 and a local hypothyroid state in muscle without changing systemic thyroid hormones [48–50]. Given the importance of thyroid hormone actions in thermogenesis and metabolism, this may be relevant to muscle thermogenesis as well.
Persistent anemia and hypoalbuminemia in rheumatoid arthritis patients with low serum triiodothyronine level
Published in Modern Rheumatology, 2020
Hideaki Tsuji, Motomu Hashimoto, Takanari Harada, Masao Tanaka, Hiromu Ito, Kosaku Murakami, Koichiro Ohmura, Takao Fujii, Tsuneyo Mimori
It is interesting that fT3 rather than fT4 is correlated with RA disease activity. In general, T3 is produced by conversion from T4 and is affected by a patient’s general condition, whereas T4 is produced directly in the thyroid gland [2]. In the presence of inflammation, T3 level can be reduced by several mechanisms: (i) suppression of TRH and TSH; (ii) reduced conversion from T4 to T3 secondary to suppression of iodothyronine deiodinase (D)1 and D2; and (iii) rapid metabolism of T3 by increasing D3 levels in liver and muscle [2]. Low-T3 syndrome is a condition where the metabolism of T3 is affected by the inflammatory state of the entire body without abnormal thyroid gland tissue [1]. Therefore, in inflammatory diseases such as RA, it is presumed that T3, rather than T4, fluctuates and correlates with RA disease activity.
Effects of maternal exposure to BDE209 on neuronal development and transcription of iodothyronine deiodinase in offspring mice
Published in Toxicology Mechanisms and Methods, 2019
Bo Qian, Chengqiang Wang, Chaochao Zhao, Rongjuan Jiang, Jiale Song
Iodothyronine deiodinase has been found associated with the homeostasis of THs. To clarify the molecular mechanisms of THs disruption induced by BDE209, mRNA expression of iodothyronine deiodinase in the livers and brains of offspring was tested. In the liver, mRNA expression of dio1 decreased by 36.08% in 1.5 mg/kg group and 91.29% in 225 mg/kg group than that in control at PND 21. By day PND 60, mRNA expression of dio1 decreased by 60.94% in 1.5 mg/kg group and 51.96% in 225 mg/kg group than that in control (p < 0.05). Compared to the control group, dio2 mRNA expression decreased by 60.73% in 1.5 mg/kg group and 62.73% in 225 mg/kg group at PND 21 (p < 0.05). dio3 mRNA expression decreased by 35.18% in 1.5 mg/kg group and 70.63% in 225 mg/kg group than that in control at PND 21(p < 0.05). By day PND 60, dio3 mRNA expression decreased by 59.80% in 1.5 mg/kg group and 51.44% in 225 mg/kg group than that in control (Figure 4). In the brain, mRNA expression of dio1 increased to 5.27 times in 1.5 mg/kg group and 1.94 times in 225 mg/kg group than that in control at PND 21 (p < 0.05). By day PND 60, dio1 mRNA expression increased to 3.74 times in 225 mg/kg group than that in control (p < 0.05). dio3 mRNA expression decreased by 51.07% in 1.5 mg/kg group and 36.16% in 225 mg/kg group than that in control at PND 21(p < 0.05). By day PND 60, dio3 mRNA expression decreased by 24.18% in 1.5 mg/kg group and 27.22% in 225 mg/kg group than that in control (Figure 5).