Beta-blockers in the treatment of hemangiomas in childhood
Authors:
J. Mališ 1; V. Stará 2; S. Klovrzová 4; L. Nováková 1; Š. Čapková 3; K. Švojgr 1; V. Jeřábková 1; S. Cyprová 1; M. Cháňová 1; J. Kozák 5; B. Kocmichová 6; A. Sukop 7; Z. Hříbal 8; R. Pádr 8; K. Bláhová 2; M. Vaculík 5; J. Starý 1
Authors place of work:
Klinika dětské hematologie a onkologie UK 2. LF a FN Motol, Prahapřednosta prof. MUDr. J. Starý, DrSc.
1; Pediatrická klinika UK 2. LF a FN Motol, Prahapřednosta prof. MUDr. J. Lebl, CSc.
2; Poliklinika FN Motol – ambulance dětské dermatologie, Prahaprim. MUDr. Š. Čapková
3; Nemocniční lékárna FN Motol, Prahavedoucí PharmDr. P. Horák
4; Neurochirurgická klinika UK 2. LF a FN Motol, Prahapřednosta doc. MUDr. M. Tichý, CSc.
5; Klinika dětské chirurgie UK 2. LF a FN Motol, Prahapřednosta prof. MUDr. J. Šnajdauf, DrSc.
6; Klinika plastické chirurgie UK 3. LF a FN Královské Vinohrady, Prahapřednosta doc. MUDr. M. Tvrdek
7; Klinika zobrazovacích metod UK 2. LF a FN Motol, Prahapřednosta prof. MUDr. M. Roček, CSc.
8
Published in the journal:
Čes-slov Pediat 2014; 69 (5): 274-282.
Category:
Original Papers
Summary
Introduction:
Infantile hemangiomas (IH) – the most common benign tumors in infants affects 10% to 12% of infants, usually spontaneously involuting, 10–20% progressing IH can cause serious functional problems or cosmetic defect. IH is divided into three groups: superficial 50–60%, subcutaneous (deep) 15%, and mixed 25–35%. The size and number of deposits is highly variable. Leaute-Labréze published (2008) first experience with the use of beta-blocker propranolol as an effective treatment for IH. Propranolol causes vasoconstriction, blocks the effects of the factors supporting the formation of new blood vessels and promotes apoptosis of endothelial cells.
Purpose of the study:
Verification of literary evidence of the effect of propranolol on its own group of children with IH.
Methods, patients and results:
103 children, boys 20 (22%) , girls 83 (78%), med. age 4.6 months. Location of IH: chest 16 (15%), liver 4 (4%) , liver + skin 2 (2%) , limbs 11 (10%), multiple localization 13 (12%), head, face 63 (58%). The target dose of propranolol 2 mg/kg/day, duration of treatment: med. 6.4 months (3 months, 2.5 years), hemangiomas of the liver treated med. 9.7 months. In 9 pts (9%) IH after discontinuation of propranolol therapy should be resumed. Superficial hemangiomas responded best, disappeared without appreciable residue. Deep hemangiomas responded slowly. Mixed hemangiomas leaving residue in 5 cases, must be removed surgically, in 3 cases the residues are treated with laser therapy. Secondary symptoms: 3 low heart rate, 2 hypoglycemia (lowest level 2.8 mmol/l), 1 skin allergic reaction to a syrup, which resolved rapidly after discontinuation. The parents observation – colder acres.
Conclusion:
Generally, this treatment appears to be a simple, efficient and safe, but some complications can be severe – bradycardia, hypoglycemia.
Key words:
hemangioma, infantile hemangioma, beta-blockers, propranolol
Zdroje
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Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
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