• The role of nonselective β-blocker in the treatment of children with problematic haemangioma of complicated anatomical localization

The role of nonselective β-blocker in the treatment of children with problematic haemangioma of complicated anatomical localization

SOVREMENNAYA PEDIATRIYA.2017.2(82):106-110; doi 10.15574/SP.2017.82.106

Gorbatyuk O. M., German O. B., Martinyuk T. V.
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
Volyn Regional Clinical Territorial Medical Association, Ukraine

Objective: to estimate the own experience of using β-blocker propranolol in the treatment of problematic haemangioma in children.

Material and methods. The study included 14 children with problematic haemangioma of various localization. The comprehensive investigation comprised common clinical and laboratory examination with consultation by a cardiologist and daily monitoring of the child's general medical condition and the cardiovascular system during three days. The general view of haemangioma and its dimensions were assessed visually and by photo fixation, and using ultrasound as well, before the administration of propranolol and after the first, third and sixth months of treatment. The first line of treatment was systemic therapy of β-blocker propranolol. One child was excluded from the study due to contraindications to the administration of β-blocker.

Results. The average duration of treatment was 6.8 months. The first signs of haemangioma regression were observed within a month after propranolol treatment. In 100% of patients after 3–4 months of the treatment, the arrest of haemangioma proliferation was revealed. Complete regression was occurred in nine (69.2%) children. In four children, the propranolol system therapy was the first step of the combined treatment. In three patients, the treatment was followed by applying of laser irradiation to remove residual telangiectasia and superficial haemangioma component, the surgery was applied in one child to remove deep haemangioma component.

Conclusions. In the case of complicated anatomical localization and the impossibility of radical removal of haemangioma as first line treatment, the systemic therapy of β-blockers is applied. Propranolol in the therapeutic dose of 2 mg/kg per day is the safety treatment of haemangioma and causes complete haemangioma regression in 69.2% of patients, while there is no side effects and complications. The method of conservative treatment of haemangioma with propranolol can be used as one of the steps of combined treatment with subsequent surgical removal of residual component of deep tumors. Superficial telangiectasia and capillary superficial tumor component can be treated with selective photothermolysis of laser radiation.

Key words: haemangioma, children, β-blocker propranolol, propranolol.

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