Propranolol as a first-line treatment of infantile hemangioma: Single center experience


Ince D., Demiraʇ B., Töret E., Oymak Y., Yaman Y., Özek G., ...More

Turkiye Klinikleri Pediatri, vol.24, no.2, pp.37-44, 2015 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 24 Issue: 2
  • Publication Date: 2015
  • Doi Number: 10.5336/pediatr.2015-45002
  • Journal Name: Turkiye Klinikleri Pediatri
  • Journal Indexes: Scopus
  • Page Numbers: pp.37-44
  • Keywords: Capillary infantile, Hemangioma, Propranolol, Treatment outcome
  • Dokuz Eylül University Affiliated: Yes

Abstract

Copyright © 2015 by Türkiye Klinikleri.Objective: Infantile hemangiomas (IHs) are the most common benign vascular tumors in infancy. Spontaneous regression is expected in majority of IHs, so watchful waiting is the best management. Currently propranolol has taken the place of corticosteroids for the treatment of risky IHs. Herein we aimed to analyze our patients with IHs treated with propranolol. Material and Methods: There were 240 patients with diagnosis of IH, treatment was indicated in 11.3% (n:27) of them, and these 27 patients received propranolol as a first-line treatment between January 2012-January 2015. Medical records of these 27 patients were analized retrospectively. Clinical characteristics, physical examination findings, treatment indications, treatment details, responses and side effects of propranolol were analized retrospectively. Results: The median age at diagnosis was 3 months (1-15), and M/F ratio was 0.23. The most common hemangioma localization was skin and head-neck region in 55.6% of patients. Treatment indications were local complications (haemorrhage, ulceration, infection) (44.4%), life threating organ dysfunction (33.3%) and relative indications (22.2%). The median follow-up period was 12 months (1-26 months). Pallor and partially regression in hemangiomas were observed between the fourth and sixth weeks in all patients. Complete remission occured in 15 patients, treatment is going on with partial remission in remaining 12 cases. There was no observed side effects of propranolol. Conclusion: Propranolol is a well-tolerated, efficacious, and safe drug for treatment of IHs. It can be initiated and administered in the outpatient setting. Treatment indications of IHs may become more flexible taking into account of the safety profile of propranolol.