PURPOSE: The purpose of this report was to describe 2 cases of periocular infantile hemangiomas (IHs) that were successfully treated with low-dose oral propranolol alone and in combination with oral prednisolone. METHODS: Two infants aged 3 months and 6 weeks, respectively, were referred for management of vision-threatening periocular IHs causing ocular displacement and obscuration of the visual axis. The first infant had a superficial left upper eyelid capillary hemangioma with extraconal extension and the second infant had a deep preseptal capillary hemangioma in the right lower eyelid with intraconal extension. Both cases were started on oral propranolol 0.5 mg/kg/day in divided doses and titrated up to 1.5 mg/kg/day as first-line therapy. The first infant was also given oral prednisolone 2 mg/kg/day during the initial first month of treatment. RESULTS: Rapid regression in sizes of the hemangiomas was seen within the first 3 days of treatment. By 2 months of therapy, both infants had achieved normal ocular alignment. The second infant experienced a transient period of hypotension after the first dose of propranolol was started but recovered spontaneously. Both infants did not experience any adverse effects of propranolol throughout the treatment period. CONCLUSIONS: Low-dose oral propranolol is an effective first-line therapy for the management of vision-threatening IH. Dose escalation in combination with oral prednisolone after pediatric assessment might be useful in avoiding adverse effects of propranolol in young infants.
PURPOSE: The purpose of this report was to describe 2 cases of periocular infantile hemangiomas (IHs) that were successfully treated with low-dose oral propranolol alone and in combination with oral prednisolone. METHODS: Two infants aged 3 months and 6 weeks, respectively, were referred for management of vision-threatening periocular IHs causing ocular displacement and obscuration of the visual axis. The first infant had a superficial left upper eyelid capillary hemangioma with extraconal extension and the second infant had a deep preseptal capillary hemangioma in the right lower eyelid with intraconal extension. Both cases were started on oral propranolol 0.5 mg/kg/day in divided doses and titrated up to 1.5 mg/kg/day as first-line therapy. The first infant was also given oral prednisolone 2 mg/kg/day during the initial first month of treatment. RESULTS: Rapid regression in sizes of the hemangiomas was seen within the first 3 days of treatment. By 2 months of therapy, both infants had achieved normal ocular alignment. The second infant experienced a transient period of hypotension after the first dose of propranolol was started but recovered spontaneously. Both infants did not experience any adverse effects of propranolol throughout the treatment period. CONCLUSIONS: Low-dose oral propranolol is an effective first-line therapy for the management of vision-threatening IH. Dose escalation in combination with oral prednisolone after pediatric assessment might be useful in avoiding adverse effects of propranolol in young infants.
Authors: Jia Wei Zheng; Ling Zhang; Qin Zhou; Hua Ming Mai; Yan An Wang; Xin Dong Fan; Zhong Ping Qin; Xv Kai Wang; Yi Fang Zhao Journal: Int J Clin Exp Med Date: 2013-10-25
Authors: Beth A Drolet; Peter C Frommelt; Sarah L Chamlin; Anita Haggstrom; Nancy M Bauman; Yvonne E Chiu; Robert H Chun; Maria C Garzon; Kristen E Holland; Leonardo Liberman; Susan MacLellan-Tobert; Anthony J Mancini; Denise Metry; Katherine B Puttgen; Marcia Seefeldt; Robert Sidbury; Kendra M Ward; Francine Blei; Eulalia Baselga; Laura Cassidy; David H Darrow; Shawna Joachim; Eun-Kyung M Kwon; Kari Martin; Jonathan Perkins; Dawn H Siegel; Robert J Boucek; Ilona J Frieden Journal: Pediatrics Date: 2012-12-24 Impact factor: 7.124