title: Hypoglycemia as a result of propranolol during treatment of infantile hemangioma: a case report.
abstract: Propranolol is a new and promising treatment for hemangiomas of infancy. We report of a patient in whom steroid maintenance therapy is successfully tapered after introduction of propranolol. This patient, however, developed symptomatic hypoglycemic events presumably because of a concurrent deficiency of epinephrine and cortisol as a direct result of both beta-blockage by propranolol and adrenal insufficiency as a result of prednisone use. Extreme care should be taken in patients treated with both propranolol and prednisone as they are at increased risk of hypoglycemia.
authors.affiliation: Department of Pediatric Cardiology, Centre for Congenital Vascular Anomalies Utrecht, University Medical Centre Utrecht/Wilhelmina Children's Hospital, Lundlaan, Utrecht, The Netherlands. h.breur@umcutrecht.nl
authors.forename: Johannes M P J
authors.initials: JM
authors.lastname: Breur
authors.forename: Marlies
authors.initials: M
authors.lastname: de Graaf
authors.forename: Corstiaan C
authors.initials: CC
authors.lastname: Breugem
authors.forename: Suzanne G M A
authors.initials: SG
authors.lastname: Pasmans
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D004347:Drug Interactions; D005260:Female; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007231:Infant, Newborn; D011241:Prednisone / Q000008:administration & dosage; D011433:Propranolol / Q000008:administration & dosage / Q000009:adverse effects*; D012878:Skin Neoplasms / Q000188:drug therapy*
chemical_list: D000319:Adrenergic beta-Antagonists; D000893:Anti-Inflammatory Agents; D011433:Propranolol; D011241:Prednisone