Treatment of haemangiomas using propranolol in paediatric patients: a retrospective cohort study

Introduction Haemangioma, one of the most common benign neoplasms of early childhood, is a significant clinical problem due to cosmetic reasons but also because of possible health complications. Aim Presentation of the method and results of treatment of infantile haemangiomas (IHs) using propranolol in a maximum dose of 3 mg/kg/day. Material and methods In 2013 to 2018 there were 108 patients with IHs multidisciplinary diagnosed and treated. 77 of them were girls and 31 were boys; all were between the ages of 2 and 21 months (mean: 6.87 months). Lesions were most often located in the head region (n = 73). The main imaging study assessing the arteriovenous flow was USG, which was used to assess the size of haemangioma and its regression or progression. Also, coagulation parameters were analysed using laboratory tests. Results Reduction of lesions occurred in 103 of 108 patients, which results in a percentage score above 95. In 19 patients, after completion of treatment, there were abnormalities of coagulation in laboratory tests whereas before the treatment, these abnormalities occurred in 82 patients. The average duration of treatment was longer than 12 months and the maximum dose of propranolol of 3 mg/kg/day was achieved after 3 to 5 months of treatment. Side effects occurred totally in 19 patients, with night anxiety and nightmares being the most common. Conclusions After achieving the maximum dose of the drug later than recommended in the Recommendation of the Polish Haemangioma and Vascular Malformations Group criteria, there was no need for longer therapy, while the effectiveness of the treatment remained unchanged. Side effects that occurred were not life-threatening or detrimental to the health of patients.

[1]  A. Kurta,et al.  Prescribing Propranolol for Hemangioma of Infancy: Assessment of Dosing Errors , 2018, Pediatrics.

[2]  U. Aiman,et al.  The Effect of Oral Propranolol versus Oral Corticosteroids in Management of Pediatric Hemangiomas , 2018, World journal of plastic surgery.

[3]  Yi Ji,et al.  Oral atenolol therapy for proliferating infantile hemangioma , 2016, Medicine.

[4]  I. M. S. Suryaguna DIAGNOSIS AND MANAGEMENT OF INFANTILE HEMANGIOMA , 2013 .

[5]  D. Bonnet,et al.  Treatment of infantile haemangiomas: recommendations of a European expert group , 2015, European Journal of Pediatrics.

[6]  Ş. Karaca,et al.  Clinical practice trends in cryosurgery: a retrospective study of cutaneous lesions , 2015, Postepy dermatologii i alergologii.

[7]  Mary Wu Chang,et al.  A Randomized, Controlled Trial of Oral Propranolol for Infantile Hemangioma , 2015 .

[8]  A. Kaszuba,et al.  Sturge-Weber syndrome type II treated with PDL 595 nm laser , 2015, Postepy dermatologii i alergologii.

[9]  K. Holland,et al.  Initiation and Use of Propranolol for Infantile Hemangioma: Report of a Consensus Conference , 2013, Pediatrics.

[10]  M. Levy Propranolol for Infantile Hemangiomas , 2012, Global advances in health and medicine.

[11]  J. Kleber,et al.  Propranolol Therapy in 55 Infants with Infantile Hemangioma: Dosage, Duration, Adverse Effects, and Outcome , 2011, Pediatric dermatology.

[12]  A. Zvulunov,et al.  Oral Propranolol Therapy for Infantile Hemangiomas Beyond the Proliferation Phase: A Multicenter Retrospective Study , 2011, Pediatric dermatology.

[13]  Małgorzata Gromkowska,et al.  Zastosowanie propranololu w leczeniu naczyniaków u dzieci , 2011 .

[14]  Kristen E Holland,et al.  Infantile hemangioma. , 2016, Pediatric clinics of North America.

[15]  F. Boralevi,et al.  Propranolol for severe hemangiomas of infancy. , 2008, The New England journal of medicine.