Abstract
【Background】 Infantile hemangioma (IH) is categorized as a benign vascular tumor, having the highest incidence among tumors that can develop during infancy. Because IH shows a spontaneous involution in general, a “wait and see” policy is commonly employed. However, there are some cases that require immediate treatment. In 2008 , the efficacy of oral administration of propranolol on IH was reported and it later was approved as a therapeutic medicine for IH in both the United States and the European Union. Through our study, we would like to share our investigations and our proposal for effective IH treatment using propranolol.
【Subjects and Methods】The subjects were 9 IH patients who were treated with propranolol over a 2 -year period before it was approved by the Japanese health insurance program. The mean age of the subjects at the start of treatment was 9.3 months (2-41 months). We administered propranolol tablets, in crushed form, with a starting dose of 0.25 mg/kg/day during hospitalization. It was gradually increased at a rate of 0.25 mg/kg/every other day until reaching a level 2 mg/kg/day. Then, the patients were discharged and were followed up at an outpatient clinic.
【Results】A reduction was observed in all cases. One of the patients needed to stop propranolol due to the appearance of
wheezing, but could continue again by the concomitant use of leukotriene receptor antagonist. In another case, temporary bradycardia with a heart rate under 50 times a minute was seen. However, the drug could be continued because it was transient and asymptomatic.
【Discussions】Currently, propranolol is covered by Japanese health insurance and the drug can be used for patients at various institutions. As for the appropriate administration and treatment, we would like to recommend that this therapy be initially performed under hospitalization. Then, after discharge, patients may be required further observation in order to properly deal with any side effects if they appear.
