Key result
In two children with hypothyroidism and asymmetric septal hypertrophy, treatment with L-thyroxine in the surviving child led to the complete resolution of hypertrophy after 18 months.
Why the study?
Does L-thyroxine treatment resolve asymmetric septal hypertrophy in children with hypothyroidism?
Case Report (n=2)
Does L-thyroxine treatment resolve asymmetric septal hypertrophy in children with hypothyroidism?
This report highlights a rare association between hypothyroidism and asymmetric septal hypertrophy in young children, demonstrating that the hypertrophy may be reversible with L-thyroxine replacement.
Should not change practice based on case reports; leaves open reversibility of pediatric septal hypertrophy with L-thyroxine.
Any echocardiographic study of two children with hypothyroidism demonstrated the presence of asymmetric septal hypertrophy. One child died aged 11 months, and pronounced thickening of the interventricular septum was confirmed at necropsy. There was also hypertrophy of the left ventricular free wall. Histological examination showed only slight muscle fibre disarray, but there was striking vacuolation and hypertrophy of muscle fibres. In the second case, a child aged five years, the asymmetric septal hypertrophy disappeared after 18 months' treatment with L-thyroxine. Furthermore, other indices of myocardial function also returned to normal. The mechanism producing asymmetric septal hypertrophy in hypothyroidism is unknown. These are the youngest cases in which this association has been reported.
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Altman et al. (1985) conducted a case report in Hypothyroidism and asymmetric septal hypertrophy (n=2). L-thyroxine was evaluated on Presence of asymmetric septal hypertrophy. In two children with hypothyroidism and asymmetric septal hypertrophy, treatment with L-thyroxine in the surviving child led to the complete resolution of hypertrophy after 18 months.
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