Therapeutic Effect of Propranolol in Mexican Patients with Infantile Hemangioma

Abstract

Background: Infantile hemangiomas are the most common childhood vascular tumors, occurring in 10 % of children aged less than 1 year. Propranolol, a β-adrenergic blocker mainly indicated for hypertension, has proven effective in treating these types of tumors. Objective: To evaluate the efficacy and adverse effects of propranolol in Mexican pediatric patients diagnosed with infantile hemangioma, treated with an extemporaneously compounded solution of propranolol. Methods: An open prospective observational study at the Children’s Hospital of the Californias in Tijuana, Mexico was performed on ambulatory pediatric patients between the ages of 3 and 12 months diagnosed with infantile hemangioma. Patients were treated with an oral solution of propranolol in doses ranging from 0.5 to 2.5 mg/kg/day. Children were monitored monthly by the physician in charge, at which time clinical and treatment data were collected. Results: Over a period of 20 months, 31 patients were treated (36 % male and 64 % female).The majority of hemangiomas were superficial (55 %), located mainly on the face. Treatment had an average duration of 10.5 months. Ninety-six percent responded to the treatment, showing decreases in size and coloration of the hemangioma. Children who started therapy before 5 months of age had a significantly better response and shorter duration of treatment. The average therapeutic dose was 1.5 mg/kg/day. Five patients experienced mild adverse effects during the first month of therapy. Conclusion: Treatment with propranolol in this group of Mexican pediatric patients proved to be safe and effective at an average dose of 1.5 mg/kg/day, reducing the size and coloration of hemangioma with a minimum incidence of adverse effects.