RT Journal Article
SR Electronic
T1 Propranolol for infantile haemangiomas: single centre experience of 250 cases and proposed therapeutic protocol
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 1132
OP 1136
DO 10.1136/archdischild-2014-306514
VO 99
IS 12
A1 Lea Solman
A1 Amera Murabit
A1 Maria Gnarra
A1 John I Harper
A1 Samira B Syed
A1 Mary Glover
YR 2014
UL http://adc.bmj.com/content/99/12/1132.abstract
AB Objective To assess the safety and efficacy of systemic propranolol for the treatment of complicated infantile haemangiomas. Design Retrospective review of case notes of paediatric patients treated with propranolol for complicated infantile haemangiomas. Setting Tertiary care children's hospital. Patients All paediatric patients with complicated infantile haemangiomas who commenced treatment with propranolol from July 2008 to December 2011 and have completed treatment for at least 3 months. Results 250 patients were treated with propranolol; 34.4% were premature and 5.6% postmature. Indications for propranolol included: vision compromise (42.0%), bleeding and/or ulceration (30.4%) airway obstruction (8.8%), feeding difficulty (8.4%), risk of permanent disfigurement (4.4%) and other (6%) (nasal obstruction, auditory canal obstruction, large haemangioma, compression of neck structure and spinal cord). Median age at beginning of treatment was 4.5 months. Median age at end of treatment was 16.7 months. Median length of therapy was 11.8 months. Adverse effects (such as wheezing, worsening of ulceration, sleep disturbance, diarrhoea) occurred in 38 patients (15.2%), leading to modifications in management in 26 patients (10.4%). 240 patients (96%) had good to excellent response to treatment. 20 patients (8%) experienced regrowth of the haemangioma on cessation of propranolol and six patients (2.4%) required propranolol to be restarted. Conclusions In appropriately selected patients, propranolol is a safe and effective treatment for infantile haemangiomas.