title: Propranolol treatment for infantile hemangioma: a case series of sixty-two patients.
abstract: Infantile hemangiomas (IH) complicated by ulceration, disfigurement, functional impairment or life-threatening conditions need early, safe and effective treatment. This study explores the impact of propranolol on complicated IH. We report our experience of 62 patients treated with oral propranolol for complicated IH. The effect of propranolol was assessed using a score on a visual analogue scale integrated with echo, magnetic resonance or endoscopic findings. The average age at the beginning of the treatment was seven months [standard deviation (SD)±8.9], with a median of four months (range 1-53 months). The average age at the end of the treatment was 15 months (SD±8.4), with a median of 13 months (range 7-59 months). The mean treatment length was eight months (SD±3.2). Oral propranolol was successful in 95.2% of the patients in reducing the volume, the intensity of color and the elevation of IH. Statistically significant improvement of IH volume was observed in the first two months of therapy (P≤0.001), and between the second month and the end of the treatment (P&lt;0.05). No significant bradycardia or hypotension occurred. Severe hypoglycemia occurred in one patient. Mild adverse effects were observed in seven patients. Our study demonstrates that propranolol administered orally at 2 to 3 mg/kg/day has a rapid therapeutic effect leading to remarkable shortening of the natural course of IH and it is safe in the majority of patients.
authors.affiliation: Department of Pediatrics, Parma University Hospital, Parma. giovanna.stringari@outlook.com.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Stringari
authors.forename: Giulia
authors.initials: G
authors.lastname: Barbato
authors.forename: Matteo
authors.initials: M
authors.lastname: Zanzucchi
authors.forename: Maddalena
authors.initials: M
authors.lastname: Marchesi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cerasoli
authors.forename: Bertrand
authors.initials: B
authors.lastname: Tchana
authors.forename: Alessandro
authors.initials: A
authors.lastname: Gritti
authors.forename: Valeria
authors.initials: V
authors.lastname: Boccaletti
authors.forename: Alfonsa Anna
authors.initials: AA
authors.lastname: Lombardi
authors.forename: Nicola
authors.initials: N
authors.lastname: Carano
mesh_terms: D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002675:Child, Preschool; D005260:Female; D006391:Hemangioma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D011433:Propranolol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol