title: Adrenal suppression and failure to thrive after steroid injections for periocular hemangioma.
abstract: OBJECTIVE
  To evaluate the effects of steroid injections for periocular capillary hemangioma on adrenal function and body composition.
  
  
  METHODS
  Noncomparative, interventional case series.
  
  
  METHODS
  Four patients with periocular hemangioma.
  
  
  METHODS
  Four white female infants with sight-threatening periocular hemangiomata received a combination of steroid injections of triamcinolone and betamethasone. In the first 2 cases, injections were perilesional and in the other 2, intralesional.
  
  
  METHODS
  The infants were monitored by serial measurements of basal serum cortisol concentrations, responses to the Synacthen stimulation test, measurement of growth and of weight gain, and, in one case, more detailed anthropometric measures of body composition.
  
  
  RESULTS
  Prolonged suppression of circulating serum cortisol concentrations and cortisol responses to the Synacthen stimulation test were noted in 3 cases, and marked failure to thrive was noted in all 4 cases.
  
  
  CONCLUSIONS
  Adrenal suppression after steroid injection for periocular capillary hemangioma is a potentially life-threatening complication. Failure to thrive is also a frequent side effect of treatment. Ophthalmologists should undertake the above treatment in consultation with a pediatric endocrinologist.
authors.affiliation: Department of Ophthalmology, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom.
authors.forename: Raina
authors.initials: R
authors.lastname: Goyal
authors.forename: Patrick
authors.initials: P
authors.lastname: Watts
authors.forename: Carol M
authors.initials: CM
authors.lastname: Lane
authors.forename: Lynn
authors.initials: L
authors.lastname: Beck
authors.forename: John W
authors.initials: JW
authors.lastname: Gregory
mesh_terms: D000309:Adrenal Insufficiency / Q000097:blood / Q000139:chemically induced*; D001623:Betamethasone / Q000009:adverse effects / Q000627:therapeutic use; D005142:Eyelid Neoplasms / Q000097:blood / Q000188:drug therapy*; D005183:Failure to Thrive / Q000097:blood / Q000139:chemically induced*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D018324:Hemangioma, Capillary / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007223:Infant; D015552:Injections, Intralesional; D014222:Triamcinolone Acetonide / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D001623:Betamethasone; D014222:Triamcinolone Acetonide; D006854:Hydrocortisone