Propranolol for infantile haemangiomas and neuroglycopenic seizures

Diagnosis and Management of Infantile Hemangioma

“…177 Less common complications include bronchospasm and hypoglycemia, the latter of which has the potential to induce seizures. 159,161,180,181 In a systematic review of propranolol treatment of IH, there were 371 total adverse effects reported in 1189 patients. 182 Those most commonly reported were sleep disturbance (136 patients), acrocyanosis (61 patients), hypotension (39 patients, including 5 considered "symptomatic"), bradycardia (8 patients, including 1 considered symptomatic), and respiratory events including infections, wheezing, and stridor (35 patients).…”

Treatment for Infantile Hemangiomas

“…[6][7][8][9][10][11][12][13] Hypoglycemia was most frequently associated with infection and poor feeding, with doses ranging from 1.0 to 4.0 mg/kg/d and occurred between 10 and 160 days after initiation of therapy. [6][7][8][9][10][11][12][13] In our series, we observed only 2 cases of mild, uncomplicated hypoglycemia, one during inpatient initiation of therapy and the other during a diarrheal illness. Our complication rate of 8.7% is similar, and in fact, lower than the average rate reported in the literature when including doses from 1 to 3 mg/kg/d.…”

Reply

“…[2][3][4][5][6][7] Recently Hogeling et al 8 reported in their randomized controlled trial side effects, including bronchiolitis, gastroenteritis, cold extremities, and sleep disturbance. So far only case reports of side effects in the treatment of infantile hemangioma with propranolol have been described but they are not scarce.…”

“…Breur 1. 5 2. 4,5 As such, I am confident that our data accurately reflect what occurred within each of the major EB subtypes in the continental United States and, based on data from most other large cohorts, that they can be generalized to other populations.…”