Pifu-xingbing zhenliaoxue zazhi (Jun 2019)

Study on adverse reactions to oral propranolol in the first week treatment of infantile hemangiomas

  • Ruo-nan ZHUGE,
  • Ping LI,
  • Jian-hong LI,
  • Jian-zhong LIU,
  • Peng-yue TANG,
  • Si-hang FENG,
  • Zhen LUO

DOI
https://doi.org/10.3969/j.issn.1674-8468.2019.03.003
Journal volume & issue
Vol. 26, no. 3
pp. 138 – 143

Abstract

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Objective: To investigate the side effects of oral propranolol for infantile hemangiomas in the first week of treatment, and to assess the necessity of hospitalization. Methods: Data from 502 inpatients with high-risk infantile hemangiomas in the first week of treatment with oral propranolol were retrospectively analyzed. Results: The patient male to female ratio was 1 ∶2.3 (152 versus 350), with mean age of 3.29±2.22 months. Lesions on the head/neck, trunk and limbs accounted for 62.75% (315), 19.32% (97) and 7.97% (40), respectively. Among 26 (5.18%) patients with multiple hemangiomas (≥5 lesions), 2 patients exhibited liver involvement. Seven cases were complicated with ulcers. Premature birth and low birth weight accounted for 7.57% (38) and 3.39% (17), respectively. Forty seven (9.36%) patients had a history of heart diseases. Prior to the treatment, 21(4.18%) cases displayed abnormal liver function and 31(6.18%) with high level of blood TSH. The total adverse reaction rate was 18.52% (93/502), including 4.58% (23/502) with bradycardia and 0.40% (2/502) with grade Ⅰ atrioventricular block, all of which were asymptomatic. Gastrointestinal reactions were observed in 12.55% (63/502) of patients, while 0.40% (2/502) of patients had poor appetite. Other adverse reactions included hypersomnia (1/502, 0.20%) and cold extremities (2/502, 0.40%). Following treatment with oral propranolol, the rates of bradycardia and gastrointestinal reactions did not differ between genders, ages and with or without premature birth, low birth weight, elevated basal TSH, abnormal basal liver function or a history of congenital heart disease (all P>0.05). Conclusions: Oral propranolol for high-risk infantile hemangiomas is relatively safe, with minor side effects. Patients without special conditions or contraindications can be treated in the clinic, without necessity of hospitalization. Dosage can be adjusted at regular follow-up visit.

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