medigraphic.com
Boletín Clínico de la Asociación Médica del Hospital Infantil del Estado de Sonora

2024, Number 2

<< Back Next >>

Bol Clin Hosp Infant Edo Son 2024; 41 (2 )

Giant Infantile Hemangioma and Its Response to Propranolol

Rodríguez GR, Rodríguez SR, Vargas ÁJE

Language: Spanish
References: 10
Page: 38-41
PDF size: 185.53 Kb.


ABSTRACT

Infantile Hemangiomas (IH) correspond to one of the most frequent dermatological disorders in pediatric age, with a prevalence of between 4 and 10 % of all newborns. Its origin is theorized from a proliferative response of vascular cells to angiogenic stimuli. Since 2014, the Food and Drug Administration (FDA) has approved the use of propranolol as a first-line medical therapy for the therapeutic management of these lesions, and although multiple clinical trials continue to be carried out, other beta blockers have not been shown to be superior to this medication. In this case, it’s a female infant, with no apparent significant history, who presented a hemangioma that encompassed the entire right orbit, and which caused eyelid ptosis of mechanical origin, in whom treatment with propranolol was started at a dose of 1 mg/kg/day. The lesion regressing almost in its entirety 10 months after starting the treatment. The use of propanol has improved the prognosis of patients with hemangiomas, reducing the rate of surgery and associated. Propranolol induces regression of hemangioma cells through inhibition of Vascular Endothelial Growth Factor A (VEGF-A), mediated by the Hypoxia-Inducible Factor 1α (HIF 1α) pathway. Possible adverse effects associated with its beta blocker mechanism must be closely monitored, but it is considered the first pharmacological option for the management of these lesions.


REFERENCES

  1. Baselga Torres E, Bernabéu Wittel J, Van EssoArbolave DL, Febrer Bosch MI, Carrasco SanzA, De Lucas Laguna R, Del Pozo Losada J, et al.Consenso español sobre el hemangioma infantil.Anales de Pediatría. [En línea]. 2016; 85(5): 256-65. Disponible en: https://doi.org/10.1016/j.anpedi. 2015.10.004

  2. Toledo-Bahena ME, Camargo-Sánchez K, Vidaurri-De La Cruz H, Valencia-Herrera AM, Sáez-deOcáriz MM, Duarte-Abdala MR, Osuna-Osuna J,et al. Guía mexicana para el diagnóstico y el tratamientodel hemangioma infantil. Boletín Médicodel Hospital Infantil de México. [En línea].2024; 81(92): 14448. Disponible en: https://doi.org/10.24875/BMHIM.24000069

  3. Rodríguez Bandera AI, Sebaratnam DF, WargonO, Wong LCF. Infantile Hemangioma. Part 1: Epidemiology,Pathogenesis, Clinical Presentationand Assessment. Journal of the American Academyof Dermatology. [En línea]. 2021; 85(6):1379-92. Disponible en: https://doi.org/10.1016/j.jaad.2021.08.019

  4. Sebaratnam DF, Rodríguez Bandera AL, WongLCF, Wargon O. Infantile Hemangioma. Part 2:Management. Journal of the American Academyof Dermatology. [En línea]. 2021; 85(6): 1395-1404. Disponible en: https://doi.org/10.1016/j.jaad.2021.08.020

  5. Kaulanjan-Checkmodine P, Oucherif S, Prey S,Gontier E, Lacomme S, Loot M, Miljkovic-Licina M,et al. Is Infantile Hemangioma a NeuroendocrineTumor? International Journal of Molecular Sciences.[En línea]. 2022; 23(9): 5140. Disponible en:https://doi.org/10.3390/ijms23095140

  6. Chu DH, Castelo-Soccio L, Wan J, Gelfand JM,Shaddy RE, Shah KN, Perman MJ, Treat JR, YanAC. Retrospective Analysis of Beta-Blocker Institutedfor Treatment of Hemangiomas (RABBITStudy). Clinical Pediatrics. [En línea]. 2014;53(11): 1084-90. Disponible en: https://doi.org/10.1177/0009922814535660

  7. El Hachem M, Gesualdo F, Diociaiuti A, Berti I,Vercellino N, Boccaletti V, Neri I, et al. Safety andEffectiveness of Oral Propranolol for Infantile HemangiomasStarted before 5 Weeks and after 5Months of Age: An Italian Multicenter Experience.Italian Journal of Pediatrics. [En línea]. 2017;43(1): 40. Disponible en: https://doi.org/10.1186/s13052-017-0357-9

  8. Léaute-Labrèze C, Boccara O, Degrugillier-ChopinetC, Mazereeuw-Hautier J, Prey S, LebbéG, Gautier S, et al. Safety of Oral Propranololfor the Treatment of Infantile Hemangioma: ASystematic Review. Pediatrics. [En línea]. 2016;138(4): e20160353. Disponible en: https://doi.org/10.1542/peds.2016-0353

  9. Shah SD, Baselga E, McCuaig C, Pope E, Coulie J,Boon LM, Garzon MC, et al. Rebound Growth of InfantileHemangiomas After Propranolol Therapy.Pediatrics. 2016; 137(4): e20151754. Disponibleen: https://doi.org/10.1542/peds.2015-1754

  10. Solman L, Glover M, Beattie PE, Buckley H, ClarkS, Gach JE, Giardini A, et al. Oral Propranolol in theTreatment of Proliferating Infantile Haemangiomas:British Society for Paediatric DermatologyConsensus Guidelines. British Journal of Dermatology.[En línea]. 2018; 179(3): 582-89. Disponibleen: https://doi.org/10.1111/bjd.16779




2020     |     www.medigraphic.com