Severe Hypoglycemia During Successful Treatment of Diffuse Hemangiomatosis with Propranolol

Bonifazi, E.; Acquafredda, Angelo; Milano, A.; Montagna, O; Laforgia, Nicola

doi:10.1111/j.1525-1470.2009.01081.x

Cited by 55 publications

(43 citation statements)

References 5 publications

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“…Serious adverse effects of propranolol in infants, such as bradycardia, hypotension, bronchospasm, hypoglycemia, hypothermia and hyperkalemia, have been reported elsewhere [28,29,30]. Although the majority of our patients did not display such findings, sleep disturbances (in approximately one third of patients) were sufficiently troublesome to warrant a dose decrement to 1 mg/kg/day.…”

Section: Discussionmentioning

confidence: 44%

Efficacy and Safety of Propranolol for the Treatment of Infantile Hemangioma: A Presentation of Ninety-Nine Cases

et al. 2014

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Background: Propranolol is highly effective in the treatment of infantile hemangioma (IH), but important clinical and pharmacological data are lacking. Objective: The aims of the present study were to evaluate the efficacy of propranolol for the treatment of IH, to identify favorable prognostic factors in propranolol-treated IH, and to evaluate the safety of propranolol for the treatment of IH. Methods: Clinical data were recorded from the electronic files and digital photographs of 99 patients with IH attending a tertiary pediatric medical center (2008-2011). Findings were evaluated by regression in volume and color changes. Results: The male-to-female ratio was 1:4. Age at treatment initiation was 9.4 ± 10.1 months; 15% of the treated hemangiomas were beyond the proliferative phase (17-54 months). The propranolol starting dose was 2 mg/kg/day. Duration of the treatment was 8.5 ± 3.2 months. All but 1 patient responded to treatment. A longer treatment course was required for segmental and deep hemangiomas. Mild side effects occurred in 32% of patients. Recurrence occurred in 13% of patients. Conclusion: Lesions located on the face are better responders when treatment is started early. Treatment should continue up to age 12-15 months, with a longer course for segmental or deep hemangiomas.

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Section: Discussionmentioning

confidence: 44%

Efficacy and Safety of Propranolol for the Treatment of Infantile Hemangioma: A Presentation of Ninety-Nine Cases

et al. 2014

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“…[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.…”

Section: Discussionmentioning

confidence: 99%

Treatment for Infantile Hemangiomas

MacIsaac

Nayar

Gehris

et al. 2016

Journal of Craniofacial Surgery

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“…Hypoglycemia in the setting of IH treated with propranolol has previously been reported. [23][24][25] As the use of propranolol in infants with IH increases, physicians must be aware of the potential for hypoglycemia. It can be particularly insidious and difficult to recognize because some symptoms that are associated with counter-regulatory epinephrine action such as sweating, shakiness, anxiety, hunger and tachycardia may be absent, due to propranolol-induced β-adrenergic blockage.…”

Section: Discussionmentioning

confidence: 99%

Propranolol treatment for infantile hemangioma: a case series of sixty-two patients

Stringari¹,

Barbato²,

Zanzucchi³

et al. 2016

Pediatr Med Chir

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Infantile hemangiomas (IH) complicated by ulceration, disfigurement, functional impairment or life-threatening conditions need early, safe and effective treatment. This study explores the impact of propranolol on complicated IH. We report our experience of 62 patients treated with oral propranolol for complicated IH. The effect of propranolol was assessed using a score on a visual analogue scale integrated with echo, magnetic resonance or endoscopic findings. The average age at the beginning of the treatment was seven months [standard deviation (SD)±8.9], with a median of four months (range 1-53 months). The average age at the end of the treatment was 15 months (SD±8.4), with a median of 13 months (range 7-59 months). The mean treatment length was eight months (SD±3.2). Oral propranolol was successful in 95.2% of the patients in reducing the volume, the intensity of color and the elevation of IH. Statistically significant improvement of IH volume was observed in the first two months of therapy (P≤0.001), and between the second month and the end of the treatment (P<0.05). No significant bradycardia or hypotension occurred. Severe hypoglycemia occurred in one patient. Mild adverse effects were observed in seven patients. Our study demonstrates that propranolol administered orally at 2 to 3 mg/kg/day has a rapid therapeutic effect leading to remarkable shortening of the natural course of IH and it is safe in the majority of patients.

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Severe Hypoglycemia During Successful Treatment of Diffuse Hemangiomatosis with Propranolol

Cited by 55 publications

References 5 publications

Efficacy and Safety of Propranolol for the Treatment of Infantile Hemangioma: A Presentation of Ninety-Nine Cases

Efficacy and Safety of Propranolol for the Treatment of Infantile Hemangioma: A Presentation of Ninety-Nine Cases

Treatment for Infantile Hemangiomas

Propranolol treatment for infantile hemangioma: a case series of sixty-two patients

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