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Ann Pediatr Endocrinol Metab > Accepted Articles
DOI: https://doi.org/10.6065/apem.2142218.109    [Accepted] Published online June 20, 2022.
Combination therapy of liothyronine and levothyroxine for hypothyroidism induced dilated cardiomyopathy
Youngha Choi1  , Se Yong Jung2, Jung Min Park2, Junghwan Suh1  , Eun Jung Shin3, Hyun Wook Chae4, Ho-Seong Kim1  , Ahreum Kwon1 
1Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
2Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
3Department of Pediatrics, Inha University Hospital, Incheon, Korea
4Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine , Seoul, Republic of Korea
Address for correspondence:  Ahreum Kwon
Email: ARMEA@yuhs.ac
Received: October 29, 2021   Revised: November 28, 2021   Accepted: December 14, 2021
Abstract
Thyroid hormone plays a vital role in regulating human metabolism. They affect the functions of major organs, such as the brain, liver, skeletal muscle, and heart. Hypothyroidism can lead to dilated cardiomyopathy and decreased heart function. In this report, we describe the case of a teenage boy who developed dilated cardiomyopathy due to hypothyroidism and considered to undergo a heart transplant. Levothyroxine monotherapy was initiated; however, there was no improvement. Thereafter, a combination therapy of liothyronine and levothyroxine was administered, the heart function was gradually restored, and he recovered completely after 6 months. Cardiac myocytes respond more specifically to liothyronine than to levothyroxine. Therefore, we suggest that liothyronine and levothyroxine combination therapy should be considered rather than levothyroxine monotherapy for hypothyroidism accompanied by heart disease.
Keywords: Thyroid hormone, Hypothyroidism, Dilated cardiomyopathy, Heart failure, Triiodothyronine, Levothyroxine
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