Clinical effect of propranolol in the treatment of respiratory hemangioma in infants and young children
CHEN Yong-Qi, ZHONG Li-Li, DING Xiao-Fang
First Affiliated Hospital of Hunan Normal University/Children's Medical Center of Hunan Provincial People's Hospital/Hunan Provincial Key Laboratory of Pediatric Respirology, Changsha 410005, China
Abstract Objective To study the clinical effect of oral propranolol in the treatment of respiratory hemangioma in infants and young children. Methods A retrospective analysis was performed from the chart review data of children with respiratory hemangioma treated by oral propranolol and diagnosed by bronchoscopy and laryngeal plain enhanced CT/MRI from November 2012 to December 2019. Results A total of 20 children were enrolled. All children had improvement in the symptoms of laryngeal stridor and dyspnea after oral administration of propranolol for 1-2 days. The median treatment time was 10 months (range 6-12 months). The median follow-up time was 10 months (range 3-15 months). Of the 20 children, 19 (95%) achieved regression of tumor, and 1 (5%) experienced an increase in tumor size during reexamination at 6 months after drug withdrawal and had no recurrence after the treatment with an increased dose of propranolol for 6 months. Only 1 child (5%) had adverse reactions, and 1 child (5%) was still under treatment. Conclusions Oral propranolol can quickly relieve the symptoms such as dyspnea and achieve tumor regression, with few adverse events, and it is therefore an effective method for the treatment of respiratory hemangioma in infants and young children.
CHEN Yong-Qi,ZHONG Li-Li,DING Xiao-Fang. Clinical effect of propranolol in the treatment of respiratory hemangioma in infants and young children[J]. CJCP, 2020, 22(7): 785-789.
CHEN Yong-Qi,ZHONG Li-Li,DING Xiao-Fang. Clinical effect of propranolol in the treatment of respiratory hemangioma in infants and young children[J]. CJCP, 2020, 22(7): 785-789.
Krowchuk DP, Frieden IJ, Mancini AJ, et al. Clinical practice guideline for the management of infantile hemangiomas[J]. Pediatrics, 2019, 143(1):e20183475.
Anderson KR, Schoch JJ, Lohse CM, et al. Increasing incidence of infantile hemangiomas (IH) over the past 35 years:correlation with decreasing gestational age at birth and birth weight[J]. J Am Acad Dermatol, 2016, 74(1):120-126.
[4]
McCormick AA, Tarchichi T, Azbell C, et al. Subglottic hemangioma:understanding the association with facial segmental hemangioma in a beard distribution[J]. Int J Pediatr Otorhinolaryngol, 2018, 113:34-37.
Darrow DH. Management of infantile hemangiomas of the airway[J]. Otolaryngol Clin North Am, 2018, 51(1):133-146.
[7]
Hardison S, Wan W, Dodson KM. The use of propranolol in the treatment of subglottic hemangiomas:a literature review and meta-analysis[J]. Int J Pediatr Otorhinolaryngol, 2016, 90:175-180.
[8]
Myer CM 3rd, O'Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes[J]. Ann Otol Rhinol Laryngol, 1994, 103(4 Pt 1):319-323.
Siegel B, Mehta D. Open airway surgery for subglottic hemangioma in the era of propranolol:is it still indicated?[J]. Int J Pediatr Otorhinolaryngol, 2015, 79(7):1124-1127.
[11]
Robitaille C, Fortin M, Trahan S, et al. Subglottic hemangioma[J]. J Bronchology Interv Pulmonol, 2016, 23(3):232-235.
[12]
Koplewitz BZ, Springer C, Slasky BS, et al. CT of hemangiomas of the upper airways in children[J]. AJR Am J Roentgenol, 2005, 184(2):663-670.
[13]
Mamlouk MD, Nicholson AD, Cooke DL, et al. Tips and tricks to optimize MRI protocols for cutaneous vascular anomalies[J]. Clin Imaging, 2017, 45:71-80.
[14]
Kitami M. Diffusion-weighted imaging as a routine MRI protocol for the evaluation of ‘infantile hemangioma’[J]. Clin Imaging, 2017, 46:121.
[15]
Ding A, Gong X, Li J, et al. Role of ultrasound in diagnosis and differential diagnosis of deep infantile hemangioma and venous malformation[J]. J Vasc Surg Venous Lymphat Disord, 2019, 7(5):715-723.
[16]
Tan ST, Wallis RA, He Y, et al. Mast cells and hemangioma[J]. Plast Reconstr Surg, 2004, 113(3):999-1011.
[17]
Starkey E, Shahidullah H. Propranolol for infantile haemangiomas:a review[J]. Arch Dis Child, 2011, 96(9):890-893.
[18]
Bitar MA, Moukarbel RV, Zalzal GH. Management of congenital subglottic hemangioma:trends and success over the past 17 years[J]. Otolaryngol Head Neck Surg, 2005, 132(2):226-231.
[19]
Hoeger PH, Harper JI, Baselga E, et al. Treatment of infantile haemangiomas:recommendations of a European expert group[J]. Eur J Pediatr, 2015, 174(7):855-865.
[20]
Léauté-Labrèze C, Dumas de la Roque E, Hubiche T, et al. Propranolol for severe hemangiomas of infancy[J]. N Engl J Med, 2008, 358(24):2649-2651.
[21]
Jadhav VM, Tolat SN. Dramatic response of propranolol in hemangioma:report of two cases[J]. Indian J Dermatol Venereol Leprol, 2010, 76(6):691-694.
[22]
Goelz R, Poets CF. Incidence and treatment of infantile haemangioma in preterm infants[J]. Arch Dis Child Fetal Neonatal Ed, 2015, 100(1):F85-F91.
[23]
Drolet BA, Frommelt PC, Chamlin SL, et al. Initiation and use of propranolol for infantile hemangioma:report of a consensus conference[J]. Pediatrics, 2013, 131(1):128-140.
[24]
Shah SD, Baselga E, McCuaig C, et al. Rebound growth of infantile hemangiomas after propranolol therapy[J]. Pediatrics, 2016, 137(4):e20151754.
Raphael MF, Breugem CC, Vlasveld FA, et al. Is cardiovascular evaluation necessary prior to and during beta-blocker therapy for infantile hemangiomas?:A cohort study[J]. J Am Acad Dermatol, 2015, 72(3):465-472.
[27]
Léauté-Labrèze C, Hoeger P, Mazereeuw-Hautier J, et al. A randomized, controlled trial of oral propranolol in infantile hemangioma[J]. N Engl J Med, 2015, 372(8):735-746.
[28]
Schwartz T, Faria J, Pawar S, et al. Efficacy and rebound rates in propranolol-treated subglottic hemangioma:a literature review[J]. Laryngoscope, 2017, 127(11):2665-2672.
