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Página de Inicio arrow Artículos Científicos arrow Propranolol for Severe Infantile Hemangiomas: Follow-Up Report
Propranolol for Severe Infantile Hemangiomas: Follow-Up Report Imprimir E-Mail
ARTICLE
Propranolol for Severe Infantile Hemangiomas: Follow-Up Report
Véronique Sans, MDa, Eric Dumas de la Roque, MDb, Jérôme Berge, MDc,
Nicolas Grenier, MDd, Franck Boralevi, MDa, Juliette
Mazereeuw-Hautier, MDe, Dan Lipsker, MDf, Elisabeth Dupuis, MDg,
Khaled Ezzedine, MDh, Pierre Vergnes, MDi, Alain Taïeb, MDa and
Christine Léauté-Labrèze, MDa
PEDIATRICS Vol. 124 No. 3 September 2009, pp. e423-e431

OBJECTIVE: Infantile hemangiomas (IHs) are the most-common soft-tissue
tumors of infancy. We report the use of propranolol to control the
growth phase of IHs.

METHODS: Propranolol was given to 32 children (21 girls; mean age at
onset of treatment: 4.2 months) after clinical and ultrasound
evaluations. After electrocardiographic and echocardiographic
evaluations, propranolol was administered with a starting dose of 2 to
3 mg/kg per day, given in 2 or 3 divided doses. Blood pressure and
heart rate were monitored during the first 6 hours of treatment. In
the absence of side effects, treatment was continued at home and the
child was reevaluated after 10 days of treatment and then every month.
Ultrasound measurements were performed after 60 days of treatment.

RESULTS: Immediate effects on color and growth were noted in all cases
and were especially dramatic in cases of dyspnea, hemodynamic
compromise, or palpebral occlusion. In ulcerated IHs, complete healing
occurred in <2 months. Objective clinical and ultrasound evidence of
longer-term regression was seen in 2 months. Systemic corticosteroid
treatment could be stopped within a few weeks. Treatment was
administered for a mean total duration of 6.1 months. Relapses were
mild and responded to retreatment. Side effects were limited and mild.
One patient discontinued treatment because of wheezing.

CONCLUSION: Propranolol administered orally at 2 to 3 mg/kg per day
has a consistent, rapid, therapeutic effect, leading to considerable
shortening of the natural course of IHs, with good clinical tolerance.
 
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