Prednisonbehandlung aus gedehnter Hämangiome

Summary

Following the recommendation of Zarem and Edgerton (1957) 9 children with various haemangiomata were treated with prednisone. 2 to 3 mg prednisone/kg bodyweight were given daily during 3 weeks, or until recession of the haemangiomata was visible. After this the dose was reduced from 1 to 2,5 mg every 3rd to 5th day. The duration of treatment varied from 7 to 19 weeks, with a total dosage from 592.5 to 1.522 mg. The Cushing-face occured in all these patients; vomitting in 2; dry skin in 2; increase of pubic hair in 2; and loss of appetite in 1 patient. All these side-effects disappeared within 2 months after treatment. Within 1 year of observation no disturbance of growth was seen. The only severe complication during prednisone-treatment, infection of the urinary tract, was limited by chemotherapy. No routine—antibiotic or gammaglobulin—prophylaxis was administered. In all cases a recession of the growth of the tumour was observed. The reaction during 1 year's observation varied from a slight skin fading (Fig. 1 and 2), to an almost complete involution (Figs. 3–8). In a 2 months old infant a rapidly growing haemangioma in the parotid region was operated on the left side, which caused a lesion of the facial nerve. At the age of 5 months prednisone was given, and this was followed by marked recession and involution of the tumour.

In a 13 months old infant with a plum-size haemangioma of the zygomatic region the involution of the tumour after Cortisone-treatment caused a depression of the soft tissue.

2 cases were lost to follow-up.

In 5 cases the effect of Cortisone-treatment varied from a slight improvement to none—in a 3 years 11 months old girl.

Although infants seem to tolerate prednisone rather well, serious complications, such as ulcer-perforation, necrosis of the head of the femur, disturbances of growth, osteoporosis and NNR-atrophy, and thromboembolic complication are always to be considered a risk with high dosage. Prednisone-treatment should therefore be reserved for excessively growing, haemangiomata where an important function or even life itself is threatened.

Zusammenfassung

Nach den Beobachtungen von Zarem und Edgerton und den Erfahrungen bei 9 eigenen Fällen sollte bei bedrohlich wachsendem, einem operativen oder sklerosierenden Eingriff nicht zugänglichen Hämangiom die parenterale Behandlung mit Prednison in Betracht gezogen werden.