title: Propranolol for infantile haemangioma: striking effect in the first weeks.
abstract: OBJECTIVE
  Discuss effect and dynamics of propranolol (PR) treatment in infantile haemangioma (IH) of head and neck in children during follow-up.
  
  
  METHODS
  Between 2010 and 2011, 22 children with head and neck infantile haemangioma (IH) treated by PR were recruited into the study. In a retrospective chart review clinical data were analyzed at 5 consecutive, different check-up time from 1 week to 12-14 months. Effectiveness of PR treatment was assessed by a symptom score method.
  
  
  RESULTS
  In the whole series a significant regression was observed in 13 patients (59%) in the first week of the therapy. Further five patients showed this time a marked, two mild improvements, and two children did not respond initially to the PR therapy. In one of them (case #8) later on a mild improvement could be seen too. At the second check-up (1 month after initiating PR therapy) 50% of children showed definitive improvement compared to the first visit. Difference between first and second check-ups was significant, and between the 4th and 5th visits the improvement showed the lowest rate. Comparison of IH regression between the 2nd and the 5th check-ups resulted in a p value a little larger than 0.05. There was not significant correlation between the initial IH severity and the treatment effectiveness at the follow-ups (p>0.05). No significant differences were found in treatment effectiveness concerning the IH localizations, too.
  
  
  CONCLUSIONS
  PR treatment is highly effective in children with IHs. The most striking effect is seen at the first week of treatment; later improvement is much slower, sometimes with periods of stagnations. The cause of this is probably the spectacular early effect of vasoconstriction, though other impacts of PR to the individual molecular markers of IH seemed to be less impressive clinically. However, treatment should be continued for at least 6 months because early cessation can cause a relapse.
authors.affiliation: Department of Pediatric Otorhinolaryngology & Bronchology, Heim Pál Children's Hospital, Budapest, Hungary. g.katona@t-online.hu
authors.forename: Gábor
authors.initials: G
authors.lastname: Katona
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Csákányi
authors.forename: Eva
authors.initials: E
authors.lastname: Gács
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Szalai
authors.forename: Gábor
authors.initials: G
authors.lastname: Ráth
authors.forename: Imre
authors.initials: I
authors.lastname: Gerlinger
mesh_terms: D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000151:congenital / Q000175:diagnosis / Q000188:drug therapy; D006391:Hemangioma / Q000151:congenital / Q000175:diagnosis / Q000188:drug therapy*; D006776:Hospitals, Pediatric; D006801:Humans; D006814:Hungary; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011433:Propranolol / Q000627:therapeutic use*; D011446:Prospective Studies; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000151:congenital / Q000175:diagnosis / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol