Propanolol: An option when treating infantil haemangioma. Clinical case.
DOI:
https://doi.org/10.34631/sporl.466Keywords:
haemangioma, propanololAbstract
Infantile haemangioma, a benign vascular tumour, is the most frequent non malignant neoplasm in children. Although spontaneous regression occurs in most cases, in about 10% of patients medical or surgical treatment is warranted due to its localization, volume or associated complications.
The authors present a case report of a 4 year old child with an infantile haemangioma of the upper lip, previously treated with systemic corticosteroids and PDL Laser, and then was submitted to medical treatment with propanolol.
Propanolol, a β-blocker, is an effective and safe option for the treatment of infantile haemangioma with aesthetic implications and/or other complications. Although its clinical use is not definitely accepted for this purpose, the excellent results obtained in the last several years have transformed this molecule into the first line of treatment in infantile haemangioma, replacing the use of systemic corticosteroids.
References
Starkey E, Shahidullah H. Propanolol for infantile hemangiomas: a review. Archives of Disease in Childhood 2011; 96: 890-3.
Drolet BA, Swanson EA, Frien IJ. Infantile hemangioma: an emerging health issue linked to an increased rate of low birth weight infants. Journal of Pediatrics 2008; 153: 712-5
Guia para el Diagnóstico y Terapéutica de los Tumores Vasculares en la Infancia; Sociedad Española de Hematología y Oncología
Pediátricas 2010
Soshana G; Bischoff J. Infantile Hemangioma - Mechanism of drug action on a vascular tumor. Cold Spring Harb Perspective Med 2011. 1:a006460
Chang LC, Haggstrom AN, Drolet BA et al. Growth Cahracteristics of Infantile Hemangiomas: Implications for management. Pediatrics 2008; 122:360-7
Li YC, McCahon E, Rowe NA et al. Successful treatment of infantile hemangioma of the orbit with propanolol. Clinical Experiment
Ophtalmology 2010; 38:554-9
Zimmermann AP, Wiegand S, Werner JA, et al. Propanolol Therapy in Infantile Haemangioma Miller: review of the literature. Internationl Journal of Pediatric Otolaryngology 2010; 74:338-42.
El-Essawy R, Galal R, Abdelbaki S. Nonselective β-blocker propanolol for orbital and periorbital hemangiomas in infants: a new first-line of treatment? Clinical Ophtalmology 2011; 5: 1639-44
Powell J. Update on hemangiomas and vascular malformations. Current Opinion Pediatr 1999; 11(5):457-63
Norman AW, Mizwicki MT, Norman DP: Steroid-hormon rapid actions, membrane receptors and a conformational ensemble model. Nature Review Drug Discovery 2004; 3: 27-41
Léauté-Labrèze C, Dumas de la Roque E, Hubiche T, Boralevi F et al. A propanolol for sever hemangiomas of infancy. New England Journal of Medicine 2008 ; 358(24) :2649-51
Buck M, Pharm D. Oral Propanolol for Hemangiomas of Infancy. Pediatric Pharmacotherapy 2010; 16: number 8
Buckmiller L, Dyamenahalli U, Richter GT. Propanolol for infantile hemangiomas: early experience at a tertiary vascular anomalies center. Laryngoscope 2010; 120:676-81
Li-Q, Yu Y, Bischoff J. Differential expression of CD146 in tissues and endothelial cells derived from infantile haemangioma and normal skin. Journal of Pathology 2003; 201:296-302
Greenberger S, Adini I, Boscolo E, Bischoff J. Targeting NF-kV in Infantile Hemangioma-derived stem cells. New England Journal of Medicine 2010; 362: 1005-13
Sanchez-Carpintero I, Ruiz-Rodriguez R. López-Gutiérrez JC. Propanolol en hemangiomas infantiles: eficacia clínica, riesgos y
recomendaciones. Actas Dermo-Sifiliográficas 2011: 102(10):766-79
Ritter MR, Butschek RA; Friedlander M. Pathogenesis of infantile hemangioma: new molecular and cellular insights. Experience Review Molecular Medicine 2007; 9 (32): 1-19
Haggstrom AN, Drolet BA, Baselga E, Chamlin SL, Garzon MC, et al. Prospective study of infantile hemangioma: clinical characteristics predicting complications and treatment. Pediatrics 2006; 118:882-7
Cushing S, Boucek RJ, Manning SC, Sidbury R, Perkins J. Initial Experience with a multidisciplinary strategy for initiation of propanolol therapy for infantile hemangioma. Otolaryngology- Head and Neck Surgery 2011; 144(1)-78-84
