title: Initial Experience With Propranolol Treatment of Lymphatic Anomalies: A Case Series.
abstract: Lymphatic malformations (LMs) are congenital lymphatic lesions that impose significant and costly morbidities on affected patients. Treatment options are limited due to incomplete understanding of LM pathobiology. Expression of an activated β2-adrenergic receptor has been described in LM tissue, suggesting that this pathway may contribute to the clinical manifestations of LM. We hypothesized that propranolol, a β-adrenergic receptor antagonist, might improve symptoms of patients with LMs and lymphatic anomalies. A retrospective chart review of patients treated with propranolol as an adjunct therapy was conducted; analyses included demographic characteristics, clinical features, and response to propranolol. Three patients with cystic and noncystic LMs displayed clinical improvement at a minimum dose of 0.7 mg/kg/d, whereas symptomatic relapses were observed when propranolol doses dropped below this threshold. Two patients with Klippel-Trenaunay syndrome demonstrated partial clinical responses with reduced edema. The fetus of a mother treated with propranolol from a gestational age of 35 weeks through delivery displayed arrested growth of a cervicofacial LM. Our retrospective review suggests that propranolol improved symptoms in a subset of patients with lymphatic anomalies. Propranolol treatment may also limit the growth of congenital LMs in utero.
authors: Departments of Surgery.
authors: June K
authors: JK
authors: Wu
authors: Pediatrics.
authors: Ellen D
authors: ED
authors: Hooper
authors: Radiology, and.
authors: Sherelle L
authors: SL
authors: Laifer-Narin
authors: Obstetrics & Gynecology, College of Physicians and Surgeons, New York, New York; and.
authors: Lynn L
authors: LL
authors: Simpson
authors: Department of Surgery, University of Chicago Medicine, Chicago, Illinois.
authors: Jessica
authors: J
authors: Kandel
authors: Departments of Surgery, Obstetrics & Gynecology, College of Physicians and Surgeons, New York, New York; and cjs2002@cumc.columbia.edu.
authors: Carrie J
authors: CJ
authors: Shawber
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D046128:Fetal Therapies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007715:Klippel-Trenaunay-Weber Syndrome / Q000175:diagnosis / Q000188:drug therapy; D044148:Lymphatic Abnormalities / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011433:Propranolol / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol