Propranolol treatment for severe infantile hemangiomas: a single-centre 3-year experience


A Georgountzou, MD, First Department of Paediatrics, Aghia Sophia Children’s Hospital, Thivon & Papadiamantopoulou, Athens 115 27, Greece.
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Aim:  To evaluate the effectiveness, safety and tolerability of propranolol as single-agent treatment in patients with problematic, proliferative-phase, infantile hemangiomas (IHs).

Methods:  Oral propranolol was administered at a dose of 2 mg/kg/day to 28 children. Cardiologic evaluation was performed before treatment initiation. Hemodynamic variables and blood glucose levels were monitored during the first 24 h of treatment, while the children were hospitalized. Clinical response and tolerance were assessed every month, along with photographic documentation. Macroscopic regression was considered the reduction >90% in the size of the IHs.

Results:  Effects on colour and growth were observed within the first month in all cases. Twenty-four patients completed treatment after a mean duration of 7.56 months, and their hemangiomas were successfully regressed. Propranolol was administered again, with satisfactory results, in three patients (12.5%) because of hemangioma regrowth. Satisfactory response is noticeable in ongoing cases. Episodes of hypotension were noted in four patients. There were no treatment interruptions because of side effects.

Conclusions:  Propranolol, as first-line treatment, yielded excellent results with very good clinical tolerance and also seems to be effective in relapses. The optimal duration of the treatment remains to be defined by long-term observation.