| Low-dose propranolol for infantile haemangioma. | |
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MedLine Citation:
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PMID: 20615772 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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In 2008, propranolol was serendipitously observed to cause accelerated involution of infantile haemangioma. However, the mechanism by which it causes this dramatic effect is unknown, the dosage empirical and the optimal duration of treatment unexplored. This study determines the minimal dosage and duration of propranolol treatment to achieve accelerated involution of problematic infantile haemangioma. Consecutive patients with problematic proliferating infantile haemangioma treated with propranolol were culled from our prospective vascular anomalies database. The patients were initially managed as inpatients and commenced on propranolol at 0.25mgkg(-1) twice daily, and closely monitored. The dosage was increased to 0.5mgkg(-1) twice daily after 24h, if there was no cardiovascular or metabolic side effect. The dosage was increased further by 0.5mgkg(-1) day(-1) until a visible effect was noticed or up to a maximum of 2mgkg(-1) day(-1), and was maintained until the lesion had fully involuted or the child was 12-months old. A total of 15 patients aged 3 weeks to 8.5 months (mean, 11 weeks) underwent propranolol treatment for problematic proliferating infantile haemangioma, which threatened life (n=1) or vision (n=2) or nasal obstruction (n=3) and/or caused ulceration (n=6) and/or bleeding (n=2) and/or significant tissue distortion (n=12). The minimal dosage required to achieve accelerated involution was 1.5-2.0mgkg(-1) day(-1). Rebound growth occurred in the first patient when the dose was withdrawn at 7.5 months of age requiring reinstitution of treatment. No rebound growth was observed in the remaining patients. No other complications were observed. Propranolol at 1.5-2.0mgkg(-1) day(-1), administered in divided doses with gradual increase in the dose, is effective and safe for treating problematic proliferating infantile haemangioma in our cohort of patients. Treatment should be maintained until the lesion is completely involuted or the child is 12-months old. Larger scale studies confirming the safety and efficacy of propranolol may broaden the indications of treatment of proliferating infantile haemangioma. |
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Authors:
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Swee T Tan; Tinte Itinteang; Philip Leadbitter |
Publication Detail:
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Type: Journal Article Date: 2010-07-07 |
Journal Detail:
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Title: Journal of plastic, reconstructive & aesthetic surgery : JPRAS Volume: 64 ISSN: 1878-0539 ISO Abbreviation: J Plast Reconstr Aesthet Surg Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-02-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101264239 Medline TA: J Plast Reconstr Aesthet Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 292-9 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Centre for the Study & Treatment of Vascular Birthmarks, Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Wellington, New Zealand; Gillies McIndoe Research Institute, Wellington, New Zealand; University of Otago, Wellington, New Zealand. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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