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correspondence

Indian Pediatr 2013;50: 521

Infantile Hemangiomas – Role of Propranolol


Prema Menon and KLN Rao

Room No. 3103, Level 3-A,  Department of Pediatric Surgery,  Advanced Pediatric Centre,
PGIMER, Chandigarh 160 012, India.
Email: [email protected]
   
 


We read with interest the recent article by Akcay, et al. on management of infantile hemangiomas [1]. In this study out of 55 patients, 16 were started on steroid therapy out of which 2 did not respond and 3 had steroid related side effects. In another 34 patients who were followed up without therapy, only 11 regressed.

Hemangiomas even when they are not life threatening cause a lot of anguish to parents as they often occur in visible areas of the head and neck region. Intralesional steroid injections [2], interferon [3] and vincristine therapy [4] have also been used. An important drug in the armamentarium now is propranolol [5]. For the past few years we have been using oral propranolol at a dose of 0.5 – 2 mg/kg/day. In as yet unpublished data we have seen excellent results uniformly with none of the side effects associated with steroid therapy. Regression was seen to occur in all patients and occurred very early at start of therapy.

References

1. Akcay A, Karakas Z, Saribeyoglu ET, Unuvar A, Baykal C, Garipardic M, et al. Infantile hemangiomas: Complications and follow-up. Indian Pediatr. 2012;49:805-9.

2. Shorr N, Seiff SR. Central retinal artery occlusion associated with perioccular corticosteroid injection for juvenile hemangioma. Ophthal Surg. 1986;17:229-31.

3. Ezekowitz RAB, Mulliken JB. Interferonalfa-2a therapy for life threatening hemangiomas of infancy. N Engl J Med. 1992;326:1456-63.

4. Enjolras O, Breviere GM, Roger G, Tovi M, Pellegrino B, Varotti E, et al. Vincristine treatment for function and life-threatening infantile hemangioma. Arch Pediatr 2004; 11:99-107

5. Leaute-Labreze C, Dumas de la Roque E, Hubiche T, Boralevi F, Thambo JB, Taieb A. Propranolol for severe hemangiomas of infancy. N Engl J Med. 2008;358: 2649-51.

 

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