title: Propranolol versus captopril in the treatment of infantile hemangioma (IH): A randomized controlled trial.
abstract: BACKGROUND
  Renin-angiotensin system components have been demonstrated in the biology of infantile hemangioma (IH). Captopril, an angiotensin-converting enzyme inhibitor, is proposed as a therapeutic alternative to oral propranolol.
  
  
  OBJECTIVE
  We sought to compare the benefit of propranolol and captopril in the treatment of IH, and to assess angiotensin-converting enzyme gene polymorphism in patients with IH and in control subjects.
  
  
  METHODS
  Thirty patients with IH and 35 healthy control subjects were enrolled in this study. Patients were randomly assigned to treatment with either propranolol or captopril. Assessment was done clinically and by measurement of serum vascular endothelial growth factor and angiotensin II in patients and control subjects. Angiotensin-converting enzyme gene polymorphism was also studied.
  
  
  RESULTS
  Clinical improvement was significantly better and faster in the patients treated with propranolol. Both groups showed reduced vascular endothelial growth factor and angiotensin II levels posttreatment, with a significantly higher percentage reduction in the propranolol-treated group. Cardiac side effects were reported only in the captopril-treated group. Baseline vascular endothelial growth factor level was significantly higher, and baseline angiotensin II level was significantly lower, in patients than control subjects.
  
  
  CONCLUSIONS
  We studied a relatively small number of patients and control subjects.
  
  
  CONCLUSIONS
  Propranolol shows greater benefit than captopril in the treatment of IH.
authors.affiliation: Department of Dermatology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Hesham
authors.initials: H
authors.lastname: Zaher
authors.affiliation: Department of Dermatology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Hoda
authors.initials: H
authors.lastname: Rasheed
authors.affiliation: Department of Dermatology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: El-Komy
authors.affiliation: Department of Dermatology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Rehab A
authors.initials: RA
authors.lastname: Hegazy
authors.affiliation: Department of Dermatology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt. Electronic address: heba.gawdat@yahoo.com.
authors.forename: Heba I
authors.initials: HI
authors.lastname: Gawdat
authors.affiliation: Department of Dermatology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Dalia M
authors.initials: DM
authors.lastname: Abdel Halim
authors.affiliation: Department of Dermatology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Rania M
authors.initials: RM
authors.lastname: Abdel Hay
authors.affiliation: Department of Pediatrics, Cairo University, Abo EL-Reesh Hospital, Cairo, Egypt.
authors.forename: Ranya A
authors.initials: RA
authors.lastname: Hegazy
authors.affiliation: Department of Clinical and Chemical Pathology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
authors.forename: Abeer M
authors.initials: AM
authors.lastname: Mohy
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002216:Captopril / Q000627:therapeutic use*; D005260:Female; D006391:Hemangioma / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D007223:Infant; D008297:Male; D007703:Peptidyl-Dipeptidase A / Q000235:genetics; D011110:Polymorphism, Genetic; D011433:Propranolol / Q000627:therapeutic use*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000235:genetics
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril; D011433:Propranolol; D007703:Peptidyl-Dipeptidase A
keywords: angiotensin II; captopril; efficacy; infantile hemangioma; propranolol; side effects; vascular endothelial growth factor