Use of propranolol in infantile haemangioma among Chinese children.
OBJECTIVE
To describe the use of propranolol as first-line treatment or as single therapy to control the proliferating phase of infantile haemangioma in Chinese children.


METHODS
Retrospective study.


METHODS
Regional hospital, Hong Kong.


METHODS
Children 3 years old or younger with facial haemangioma who took oral propranolol between 1 December 2008 and 1 December 2009.


RESULTS
There were 12 such patients, all of whom underwent prior clinical evaluation before starting the treatment. Ten patients had a solitary facial haemangioma and two had multiple haemangiomas. The mean age of symptom onset was 12 days. The mean age for starting propranolol treatment was 7 months, and in all cases a clinical response was observed within 7 days. Five (41%) of the patients had complete resolution 2 to 6 months after starting medication, at which time they were 5 to 12 months old. Two of them had a recurrence of the haemangioma within 8 weeks of stopping the drug, but responded to a second treatment course. In these two patients, the propranolol dosage had been tailed down rapidly and the therapy was of a shorter duration than in those without recurrence. The remaining seven patients are still taking propranolol and responding satisfactorily. Hypotension was observed in two patients, one of whom tolerated a lower dose and in the other, therapy was reinitiated at her older age. No serious side-effect was encountered in the remaining patients.


CONCLUSIONS
Propranolol was useful as first-line or single-agent treatment of facial infantile haemangioma in Chinese children, and gave rise to minimal side-effects. Although recurrence of infantile haemangioma occurred after propranolol was tailed off rapidly after a relatively short duration, an optimal treatment duration and tapering schedule has not yet been defined. Nevertheless, patients responded well to second courses of propranolol therapy.
Chik
K K
KK
Department of Paediatrics, United Christian Hospital, Kwun Tong, Hong Kong. kkchik@gmail.com
Luk
C K
CK
Chan
H B
HB
Tan
H Y
HY
D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005145:Face; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000188:drug therapy* / Q000473:pathology; D006723:Hong Kong; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local; D011433:Propranolol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D011433:Propranolol