European Journal of Pediatrics

, Volume 172, Issue 5, pp 653–659

Preliminary experience on treatment of infantile hemangioma with low-dose propranolol in China

  • Xiaorong Ma
  • Tinghui Zhao
  • Yan Xiao
  • Jie Yu
  • Huiping Chen
  • Yinying Huang
  • Jun Liu
  • Jun Lin
  • Tianxiang Ouyang
Original Article

DOI: 10.1007/s00431-012-1928-9

Cite this article as:
Ma, X., Zhao, T., Xiao, Y. et al. Eur J Pediatr (2013) 172: 653. doi:10.1007/s00431-012-1928-9

Abstract

We aimed to assess the efficacy and safety of low-dose propranolol for treatment of infantile hemangiomas (IHs) in China. Our prospective study included data from 89 patients with IH, aged 1–12 months. Plasma renin activity, angiotensin II, and aldosterone were measured before initiation of propranolol therapy. Patients were administered propranolol (0.75–1 mg/kg/day) under close observation. The volume, texture, and color of lesions were used to evaluate efficacy. Safety endpoints included heart rate, systolic and diastolic blood pressures, alanine transaminase, aspartate transaminase, thyroid function tests, and fasting blood glucose. Adverse effects were recorded. Mean plasma angiotensin II concentration in patients with IH was higher than that in age-matched healthy children, whereas mean plasma renin activity was lower. Mean aldosterone level was higher at 1–3 months but lower at 4–12 months, than values reported previously. After propranolol therapy for 6 months, IH regression was classed as grade IV in 44 patients (49.4 %), grade III in 21 patients (23.6 %), and grade II in 24 patients (27.0 %); none were grade I. Mild adverse effects, including diarrhea, restless sleep, nausea, cold extremities, and hypoglycemia, occurred in 12 patients (13.5 %). Slight decreases in heart rate and blood pressure occurred in all patients (p < 0.05). The IHs of four patients (4.5 %) relapsed after treatment cessation at 4–5 months. Conclusion: Low-dose propranolol is effective and safe for Chinese children with IH, and larger-scale studies are merited. Mechanisms underlying IH pathogenesis, and possible involvement of the renin–angiotensin–aldosterone system, deserve study.

Keywords

PropranololInfantile hemangiomaLow dosageSafety

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Xiaorong Ma
    • 1
  • Tinghui Zhao
    • 1
  • Yan Xiao
    • 1
  • Jie Yu
    • 1
  • Huiping Chen
    • 1
  • Yinying Huang
    • 1
  • Jun Liu
    • 1
  • Jun Lin
    • 1
  • Tianxiang Ouyang
    • 1
  1. 1.Department of Plastic and Reconstructive Surgery, Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghaiPeople’s Republic of China