Propranolol was introduced as a treatment for infantile hemangiomas (IH). We report a summary of 13 cases of IH treated with propranolol and discuss its effectiveness. In our series, propranolol therapy was initiated at the mean age of 4.1 months (1-8 months), and the mean therapy duration was 15 months (9-20 months). All patients showed good clinical response. Only one patient experienced asymptomatic hypoglycemia as the side effect of the drug. To avoid the side effect, the dose was increased slowly, with a feeding interval of 3 or 4 hours. Under these conditions, hypoglycemia did not recur, which enabled treatment continuation. Propranolol conferred a risk of bronchial constriction that lead to wheezy bronchitis. One patient had wheezy respiration when he contracted a viral infection, during which time he stopped taking propranolol and resumed the treatment after 1 week. She showed no deterioration of bronchial symptoms and could complete the therapy.
Adverse events such as hypoglycemia or low blood pressure might lead to a serious condition; thus, during therapy initiation, hospitalization and careful monitoring are needed. During home care after the initial hospitalization, frequent feeding and careful observation should be recommended with the medical staff's advice. With these considerations about adverse effects, propranolol therapy seems safe, effective, and easy, and should be the first-line therapeutic option.
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