Hypoceruloplasminemia: an unusual biochemical finding in a girl with Hashimoto's thyroiditis and severe hypothyroidism

  • Mariella Valenzise | mvalenzise@unime.it Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.
  • Federica Porcaro Respiratory Unit, Academic Department of Pediatrics, Bambino Gesù Children’s Hospital, Rome, Italy.
  • Giuseppina Zirilli Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.
  • Filippo De Luca Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.
  • Maurizio Cinquegrani Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
  • Tommaso Aversa Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.

Abstract

Clinical picture of Hashimoto’s thyroiditis (HT) may significantly vary in pediatric age, ranging from euthyroidism to subclinical hypothyroidism or hyperthyroidism; only rarely HT presentation may be characterized by a severe hypothyroidism also in pediatric age. Here we describe a 3-year-old Caucasian girl who was admitted to our Clinic due to pericardial effusion, muscle weakness and weight gain. At clinical examination, she presented with bradycardia, pale and round face, pseudohypertrophy of calf muscles and no pitting edema of the limbs. Routine blood investigations showed high serum aspartate and alanine aminotransferase levels, low serum ceruloplasmin without clinical signs of Wilson’s disease, dyslipidemia. Thyroid function tests revealed a picture of severe hypothyroidism associated with HT. After the replacement treatment with L-T4, thyroid-stimulating hormone serum levels gradually decreased, with concomitant resolution of pericardial effusion and normalization of ceruloplasmin levels.

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Published
2018-12-05
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Section
Case Reports
Keywords:
Hashimoto’s thyroiditis, thyroid function evolution, thyroid status prognosis, hypoceruloplasminemia
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How to Cite
Valenzise, M., Porcaro, F., Zirilli, G., De Luca, F., Cinquegrani, M., & Aversa, T. (2018). Hypoceruloplasminemia: an unusual biochemical finding in a girl with Hashimoto’s thyroiditis and severe hypothyroidism. La Pediatria Medica E Chirurgica, 40(2). https://doi.org/10.4081/pmc.2018.179