Tijdschrift voor Kindergeneeskunde

, Volume 81, Issue 2, pp 37–43 | Cite as

Peri-oculaire infantiele hemangiomen behandeld met propranolol

  • Maarten J. Ottenhof
  • Marije J. Bruggink-Hoornweg
  • Peerooz Saeed
  • Chantal M.A.M. van der Horst
Een case serie
  • 29 Downloads

Samenvatting

Doel.

Het evalueren van de effectiviteit en bijwerkingen van propranolol in de behandeling van peri-oculaire infantiele hemangiomen (IH’s).

Methoden.

Een longitudinale retrospectieve studie onder zuigelingen met peri-oculaire IH’s die met systemisch propranolol werden behandeld in het AMC. Invloed op het visuele systeem werd met oogheelkundige metingen vervolgd. Verandering van het volume van de IH’s werd voor en na behandeling fotografisch vastgelegd. Bijwerkingen werden geregistreerd.

Resultaten.

Twaalf zuigelingen met peri-oculaire IH’s werden met propranolol behandeld en vervolgd. Bij elf patiënten (92%) werd fotografisch een sterke afname in volume vastgesteld, waardoor oculaire complicaties afnamen. Bij één patiënt bleek geen effect van de propranololbehandeling waarneembaar. Bij acht van de tien patiënten verdween de amblyopie, bij de overige twee was er sprake van een verbetering van de visus. De mediane behandelduur was 5,5 maand (1,25-10,7). Bijwerkingen waren zeldzaam en niet ernstig.

Conclusie.

Propranolol is een effectief en veilig middel om perioculaire IH’s te behandelen en complicaties te voorkomen, zonder klinisch relevante bijwerkingen.

Summary

Goal.

To evaluate the effect and potential side effects of propranolol in the treatment of peri-ocular localized infantile hemangiomas (IH’s).

Methods.

We conducted a longitudinal retrospective study to assess the effect of propranolol in infants with peri-ocular IH’s who were referred to the Academic Medical Centre in Amsterdam. Ophthalmological evaluation was conducted to assess influence on visus and photographs were taken before and after treatment to evaluate changes in IH volume. Potential side effects were registered.

Results.

Twelve infants were treated with propranolol according to our set protocol. In eleven patients (92%) the IH responded to propranolol treatment. Diminished amblyopia after treatment was observed in eight out of ten patients. In one patient the IH did not respond to propranolol treatment. In all other patients a substantial decrease in size was photographically documented. The median duration of treatment was 5.5 months (1.25-10.7). Few side-effects were reported, none of them severe.

Conclusion.

Propranolol is an effective and safe agent to treat periocular IH’s and prevent complications, without significant sideeffects in our series.

Literatuur

  1. 1.
    Haggstrom AN, Drolet BA, Baselga E, et al. Prospective study of infantile hemangiomas: clinical characteristics predicting complications and treatment. Pediatrics. 2006;118:882-7.PubMedCrossRefGoogle Scholar
  2. 2.
    Léauté-Labrèze C, Dumas de la Roque E, Hubiche T, et al. Propranolol for severe hemangiomas of infancy. N Engl J Med, 2008;358:2649-51.PubMedCrossRefGoogle Scholar
  3. 3.
    Goldberg NS, Rosanova MA. Periorbital hemangiomas. Dermatol Clin. 1992;10:653-61.PubMedGoogle Scholar
  4. 4.
    Al Dhaybi R, Superstein R, Milet A, et al. Treatment of periocular infantile hemangiomas with propranolol: case series of 18 children. Ophthalmology. 2011;118:1184-8.PubMedCrossRefGoogle Scholar
  5. 5.
    Claerhout I, Buijsrogge M, Delbeke P, et al. The use of propranolol in the treatment of periocular infantile haemangiomas: a review. Br J Ophthalmol. 2011;95:1199-202.PubMedCrossRefGoogle Scholar
  6. 6.
    Fay A, Nguyen J, Jakobiec FA, et al. Propranolol for isolated orbital infantile hemangioma. Arch Ophthalmol. 2010;128:256-8.PubMedCrossRefGoogle Scholar
  7. 7.
    Rosbe KW, Suh KY, Meyer AK, et al. Propranolol in the management of airway infantile hemangiomas. Arch Otolaryngol Head Neck Surg. 2010;136: 658-65.PubMedCrossRefGoogle Scholar
  8. 8.
    Tambe K, Munshi V, Dewsbery C, et al. Relationship of infantile periocular hemangioma depth to growth and regression pattern. J AAPOS. 2009; 13:567-70.PubMedCrossRefGoogle Scholar
  9. 9.
    Hermans DJ, Ottenhof MJ, Wijnen MH, et al. Behandeling van infantiele hemangiomen met propranolol. Ned Tijdschr Geneeskd. 2011;155: A3482.PubMedGoogle Scholar
  10. 10.
    Bennett ML, Fleischer AB Jr, Chamlin SL, Frieden IJ. Oral corticosteroid use is effective for cutaneous hemangiomas: an evidence-based evaluation. Arch Dermatol. 2001;137:1208-13.PubMedGoogle Scholar
  11. 11.
    Zarem HA, Edgerton MT. Induced resolution of cavernous hemangiomas following prednisolone therapy. Plast Reconstr Surg. 1967;39:76-83.PubMedCrossRefGoogle Scholar
  12. 12.
    George ME, Sharma V, Jacobson J, et al. Adverse effects of systemic glucocorticosteroid therapy in infants with hemangiomas. Arch Dermatol. 2004; 140:963-9.PubMedCrossRefGoogle Scholar
  13. 13.
    Hogeling M, Adams S,Wargon O. A randomized controlled trial of propranolol for infantile hemangiomas. Pediatrics. 2011;128:e259-66.PubMedCrossRefGoogle Scholar
  14. 14.
    Cheng JF, Gole GA, Sullivan TJ. Propranolol in the management of periorbital infantile haemangioma. Clin Experiment Ophthalmol. 2010;38:547-53.CrossRefGoogle Scholar
  15. 15.
    Fridman G, Grieser E, Hill R, et al. Propranolol for the treatment of orbital infantile hemangiomas. Ophthal Plast Reconstr Surg 2011;27:190-4.PubMedGoogle Scholar
  16. 16.
    Haider KM, Plager DA, Neely DE, et al. Outpatient treatment of periocular infantile hemangiomas with oral propranolol. J AAPOS. 2010;14:251-6.PubMedCrossRefGoogle Scholar
  17. 17.
    Mishra A, Holmes WJ, Gorst C, Liew SH. Role of propranolol in the management of periocular hemangiomas. Plast Reconstr Surg. 2010;126:671.PubMedGoogle Scholar
  18. 18.
    Sans V, Dumas de la Roque E, Berge J, et al. Propranolol for severe infantile hemangiomas: follow- up report. Pediatrics. 2009;124:e423-31.PubMedCrossRefGoogle Scholar
  19. 19.
    Awadein A, Fakhry MA. Evaluation of intralesional propranolol for periocular capillary hemangioma. Clin Ophthalmol. 2011;5:1135-40.PubMedCrossRefGoogle Scholar
  20. 20.
    Moehrle M, Léauté-Labrèze C, Schmidt V, et al. Topical timolol for small hemangiomas of infancy. Pediatr Dermatol. 2013;30:245-9.CrossRefGoogle Scholar
  21. 21.
    Xu G, Lv R, Zhao Z, Huo R. Topical propranolol for treatment of superficial infantile hemangiomas. J Am Acad Dermatol. 2012;67:1210-3.PubMedCrossRefGoogle Scholar
  22. 22.
    Kunzi-Rapp K. Topical propranolol therapy for infantile hemangiomas. Pediatr Dermatol. 2012; 29:154-9.PubMedCrossRefGoogle Scholar
  23. 23.
    Love JN, Sikka N. Are 1-2 tablets dangerous? Betablocker exposure in toddlers. J Emerg Med. 2004; 26:309-14.PubMedCrossRefGoogle Scholar
  24. 24.
    Brandling-Bennett HA, Metry DW, Baselga E, et al. Infantile hemangiomas with unusually prolonged growth phase: a case series. Arch Dermatol. 2008; 144:1632-7.PubMedCrossRefGoogle Scholar
  25. 25.
    Leonardi-Bee J, Batta K, O’Brien C, Bath-Hextall FJ. Interventions for infantile haemangiomas (strawberry birthmarks) of the skin. Cochrane Database Syst Rev. 2011;(5):CD006545.Google Scholar
  26. 26.
    Janmohamed SR, Madern GC, Nieuwenhuis K, et al. Evaluation of intra-lesional corticosteroids in the treatment of peri-ocular haemangioma of infancy: still an alternative besides propranolol. Pediatr Surg Int. 2012;28:393-8.PubMedCrossRefGoogle Scholar

Copyright information

© Bohn, Stafleu van Loghum 2013

Authors and Affiliations

  • Maarten J. Ottenhof
    • 1
  • Marije J. Bruggink-Hoornweg
    • 1
  • Peerooz Saeed
    • 1
  • Chantal M.A.M. van der Horst
    • 1
  1. 1.AMCAmsterdamThe Netherlands

Personalised recommendations