Hong Kong Med J 2010;16:341–6 | Number 5, October 2010
Use of propranolol in infantile haemangioma among Chinese children
KK Chik, CK Luk, HB Chan, HY Tan
Department of Paediatrics, United Christian Hospital, Kwun Tong, Hong Kong
OBJECTIVE. To describe the use of propranolol as first-line treatment or as single therapy to control the proliferating phase of infantile haemangioma in Chinese children.
DESIGN. Retrospective study.
SETTING. Regional hospital, Hong Kong.
PATIENTS. Children 3 years old or younger with facial haemangioma who took oral propranolol between 1 December 2008 and 1 December 2009.
RESULTS. There were 12 such patients, all of whom underwent prior clinical evaluation before starting the treatment. Ten patients had a solitary facial haemangioma and two had multiple haemangiomas. The mean age of symptom onset was 12 days. The mean age for starting propranolol treatment was 7 months, and in all cases a clinical response was observed within 7 days. Five (41%) of the patients had complete resolution 2 to 6 months after starting medication, at which time they were 5 to 12 months old. Two of them had a recurrence of the haemangioma within 8 weeks of stopping the drug, but responded to a second treatment course. In these two patients, the propranolol dosage had been tailed down rapidly and the therapy was of a shorter duration than in those without recurrence. The remaining seven patients are still taking propranolol and responding satisfactorily. Hypotension was observed in two patients, one of whom tolerated a lower dose and in the other, therapy was reinitiated at her older age. No serious side-effect was encountered in the remaining patients.
CONCLUSION. Propranolol was useful as first-line or single-agent treatment of facial infantile haemangioma in Chinese children, and gave rise to minimal side-effects. Although recurrence of infantile haemangioma occurred after propranolol was tailed off rapidly after a relatively short duration, an optimal treatment duration and tapering schedule has not yet been defined. Nevertheless, patients responded well to second courses of propranolol therapy.
Key words: Adrenergic beta-antagonists; Facial neoplasms; Hemangioma; Infant; Propranolol
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