Multiple gastrointestinal hemangiomatosis successfully treated with propranolol.
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p e A 16-year-old boy presented with fatigue for 2 months and severe anemia (hemoglobin 4.9 g/dL). Physical examination was normal except pale skin, and no extraintestinal hemangiomatous lesion was found. Endoscopy revealed multiple cavernous hemangiomas in the stomach and colon (Fig. 1). Propranolol was started and gradually increased weekly to 2 mg 1 kg 1 d . The patient had no further complaints, and repeat endoscopic findings after 8 months showed significant decrease in size of the hemangiomas (Fig. 2). Recent discoveries concerning hemangioma pathogenesis provide both an improved understanding and more optimal approach to the evaluation and management of these patients (1). In 2008, propranolol was described as an effective treatment for infantile hemangiomas (2). Presently, propranolol is recommended as first-line treatment for infantile hemangiomas in many organs such as the liver (3). Oral propranolol gives providers a therapeutic ings after 8 months; cardia (A), corpus (B), and colon (C–E).
[1] L. Eichenfield,et al. Infantile Hemangiomas: An Update on Pathogenesis and Therapy , 2013, Pediatrics.
[2] T. Huisman,et al. Multifocal infantile hepatic hemangiomas—imaging strategy and response to treatment after propranolol and steroids including review of the literature , 2012, European Journal of Pediatrics.
[3] F. Boralevi,et al. Propranolol for severe hemangiomas of infancy. , 2008, The New England journal of medicine.