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2014, Number 1

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AMC 2014; 18 (1)

The use of propanolol in the treatment of complicated infantile hemangioma

Albornoz LCM, Oliva CCM, Bueno RR, Arranz PJC

Language: Spanish
References: 57
Page: 146-460
PDF size: 907.58 Kb.


ABSTRACT

Background: hemangiomas are the most frequent benign tumors in childhood. In the 20 % of the cases a hemangioma, during its growth, may provoke complications caused by compression and obstruction of important structures like the eyes, nose, mouth, and airways. A type of treatment is recommended for these patients.
Objective: to provide an alternative for the treatment of complicated infantile hemangiomas with the use of propanolol taken orally.
Method: a bibliographic review of the literature of the last five years about the treatment of complicated infantile hemangiomas with propanolol was made.
Development: the common treatment for complicated infantile hemangiomas was made with systemic corticosteroids (prednisone taken orally, with a daily dose of 2 to 4 mg/kg during six weeks) and alternately with interferon-alpha-2b, laser, sclerotherapy, cytokines, radiotherapy, and cryosurgery. Nevertheless, some of these methods are very expensive and may cause significant systemic effects. Many studies indicate the effectiveness of the systemic propanolol in the treatment of complicated infantile hemangiomas with encouraging results and few side effects. Although the mechanism by means of which this medicament works is not well known, it is believed that it can be related to the control of cell hypoxia, the induction of apoptosis of the endothelial cells, and the inhibition of the endothelial and fibroblast growth factor. Most of the reviewed reports showed changes in the color and size of the lesions just a few weeks from its beginning.
Conclusions: propanolol must be considered as the first line of treatment for complicated infantile hemangiomas because of its high effectiveness and safety. Its use is recommended in the secondary care level.


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