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J Am Acad Dermatol. 2011 Aug;65(2):320-327. doi: 10.1016/j.jaad.2010.06.048. Epub 2011 May 20.

Adverse effects of propranolol when used in the treatment of hemangiomas: a case series of 28 infants.

Author information

1
Department of Pediatric Dermatology & Allergology, Center for Congenital Vascular Anomalies Utrecht, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: m.degraaf-10@umcutrecht.nl.
2
Department of Pediatric Cardiology, Center for Congenital Vascular Anomalies Utrecht, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
3
Department of Pediatric Hematology, Center for Congenital Vascular Anomalies Utrecht, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
4
Department of Pediatric Dermatology & Allergology, Center for Congenital Vascular Anomalies Utrecht, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
5
Department of Pediatric Plastic Surgery, Center for Congenital Vascular Anomalies Utrecht, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.

Abstract

BACKGROUND:

Infantile hemangioma (IH) is a frequently encountered tumor with a potentially complicated course. Recently, propranolol was discovered to be an effective treatment option.

OBJECTIVE:

To describe the effects and side effects of propranolol treatment in 28 children with (complicated) IH.

METHODS:

A protocol for treatment of IH with propranolol was designed and implemented. Propranolol was administered to 28 children (21 girls and 7 boys, mean age at onset of treatment: 8.8 months).

RESULTS:

All 28 patients had a good response. In two patients, systemic corticosteroid therapy was tapered successfully after propranolol was initiated. Propranolol was also an effective treatment for hemangiomas in 4 patients older than 1 year of age. Side effects that needed intervention and/or close monitoring were not dose dependent and included symptomatic hypoglycemia (n = 2; 1 patient also taking prednisone), hypotension (n = 16, of which 1 is symptomatic), and bronchial hyperreactivity (n = 3). Restless sleep (n = 8), constipation (n = 3) and cold extremities (n = 3) were observed.

LIMITATIONS:

Clinical studies are necessary to evaluate the incidence of side effects of propranolol treatment of IH.

CONCLUSIONS:

Propranolol appears to be an effective treatment option for IH even in the nonproliferative phase and after the first year of life. Potentially harmful adverse effects include hypoglycemia, bronchospasm, and hypotension.

PMID:
21601311
DOI:
10.1016/j.jaad.2010.06.048
[Indexed for MEDLINE]

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