Adrenal suppression and failure to thrive after steroid injections for periocular hemangioma.
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.
Goyal
Raina
R
Department of Ophthalmology, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, United Kingdom.
Watts
Patrick
P
Lane
Carol M
CM
Beck
Lynn
L
Gregory
John W
JW
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
D005938:Glucocorticoids; D001623:Betamethasone; D014222:Triamcinolone Acetonide; D006854:Hydrocortisone