Propranolol Tedavisi Başarısında Hemanjiyomun Yeri ve Hasta Yaşı ile İlişkisi: Retrospektif Çalışma

Abstract

Objectiveː Propranolol causes shrinkage of hemangiomas through capillary vasoconstriction, increased endothelial cell apoptosis, and decreased vascular endothelial growth factors. This study aimed to evaluate the relationship between propranolol treatment success, the location of hemangioma and patient age. Material and Methodsː Children with hemangiomas treated with propranolol between October 2016 and April 2019 were evaluated retrospectively. Propranolol was administered as 0.5 mg/kg/day. Vital signs, blood pressure and blood glucose were monitored while the dose was gradually increased to 2 mg/kg/day. Paling and shrinking of the lesions in monthly follow-ups were considered as success of the treatment. Resultsː The median treatment age in 31-children (61.3% females, 38.9% males) with hemangiomas was 6-month (1 months-16 years), the mean treatment duration was 7.74±3.66months (3 months-18 months). Hemangiomas located in head/neck-17 cases(54.8%), in trunk- 4 cases (12.9%), in genital/gluteal -4 cases(12.9%), in abdomen-4 cases (12.9%) and on extremities-3 cases (7%). Four (12.9%) patients had multiple hemangiomas. Three (9.7%) had hepatic hemangioma diagnosed prenatally. 51.6% of were between 1-3 cm2 . Blood glucose levels were stable in all. Propranolol therapy was ineffective in 4-patient aged 7, 8, 29, and 90-month, 3 with head and neck hemangiomas and 1 with trunk hemangioma. In 27-patient who had treatment success, propranolol was discontinued when the reduction in lesion size stabilized. Conclusionː Propranolol is preferred because of its ease of use, low side effects, cost-effectiveness, and rapid response. It can be successfully used even in liver hemangiomas by close monitoring of vital signs, blood sugar, and blood pressure. Treatment success of propranolol is independent of age and hemangioma location.