Role of Propranolol in Management of Infantile Haemangioma: Our Experience

Abstract

Background: Infantile hemangiomas are the most common vascular tumors in infants and the most common benign soft-tissuetumors in infants and children with a prevalence of 4-10%. Most of the haemangiomas are self-resolving by the age of 7 years butfew present as a challenge for management. Up to 30% require treatment like systemic corticosteroids, laser therapy, interferon-a,cryotherapy, embolization, radiotherapy, and intralesional sclerotherapy, all showing variable results. Since 2008 propranolol iseffective in the management of challenging cases. At present, although many international and national studies have been done toevaluate different treatment modalities of infantile hemangioma, none is done in our local setups. Moreover, there is no specificagreed dose or guidelines. for the use of propranolol in the management of infantile hemangioma for which our results can help.Objectives: This study aimed to evaluate the therapeutic effect of propranolol in the management of infantile hemangioma in ourpopulation to help in developing a proper dose regime with minimum adverse effects.Materials And Methods: This prospective interventional study was conducted in the department of Pediatric surgery Bacha KhanMedical Complex, Swabi, Pakistan. The duration of the study was 26 months. After detailed history and investigation, the patientswere started on a lower dose (1mg/kg/day in three divided doses) of propranolol and observed for six hours in the ward. After oneweek the dose was increased (2 mg/kg/day in three divided doses). The outcome was presented in terms of the percentage ofregression of the mass as effective or non-effective.Results: A total of 18 patients were treated with propranolol with a male to female ratio of 1:4. All patients tolerated the dose and hadminimal side effects. All patients responded to the treatment with some early responders (n=16, 88.8%) while others respondinglate.Conclusion: Our study showed that propranolol starting at a low dose after six months of age with gradually increasing it can havea good outcome with minimal side effects. Hence looking at its safety, we can say that propranolol can be given for small and nonproblematic hemangiomas as well.Keywords: Infantile Hemangioma, therapeutic effect, propranolol