Clinical evaluation of infantile hemangiomas treated with atenolol

Ballona, Rosalía; Zevallos, Jean; Núñez, Jeanette

doi:10.5070/d32612051348

Cited by 3 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…18 When patients do require treatment, case reports have focused on embolization, excision, and ligation. 6,13,17,18 However, cardiac complications may preclude the anesthesia necessary for intervention and also drastically increase the risk of any procedural approach. Owing to the location and the vessels involved in our patient's case, mass resection would likely have required forequarter amputation; embolization was pursued only as a last resort as the size, number, and tortuosity of the feeding vessels was likely to prevent complete technical success and contribute to complex devascularization issues.…”

Section: Discussionmentioning

confidence: 99%

“…2 Corticosteroids, propranolol, and vincristine have been used with minimal success, and only embolization and surgical resection have been shown to be definitive. 9,13,14 We present a rare, and sadly lethal, case of a neonate with a large CH and severe, overwhelming coagulopathy and multiorgan failure.Treatment options, which were carefully weighed for our patient, are…”

mentioning

confidence: 99%

See 1 more Smart Citation

Catastrophic congenital hemangioma with severe coagulopathy leading to fatal cardiac failure: Case report and review

Cohen‐Cutler

Szymanski

Bockoven

et al. 2021

Pediatric Dermatology

View full text Add to dashboard Cite

Congenital hemangiomas (CH) are rare vascular tumors of the neonate, with an estimated incidence of less than 0.5%. 1 CH are present at birth and may involute to varying degrees over the first 2-12 months of age. 2 Based on the course and degree of involution, CH are subdivided into rapidly, partially, and non-involuting subtypes. [3][4][5] Complications of CH are rare and primarily related to high-flow vasculature that may initially be present before the involution phase begins. The most common sequela of this includes ulceration and bleeding, particularly in the peripartum period. 6,7 High-output congestive heart failure can rarely result from intralesional shunting in larger CH, particularly those within visceral organs. Increased blood flow can also lead to a mild coagulopathy, evidenced by hypofibrinogenemia and thrombocytopenia. 2,[8][9][10][11] These findings are usually transient and less severe than Kasabach-Merritt phenomenon (KMP), which occurs most commonly in patients with kaposiform hemangioendotheliomas (KHE) and less so with tufted angiomas (TA). 12 Typically, CH can be managed supportively and expectantly.However, in cases requiring intervention, a lack of evidence in favor of medical therapies was found. 2 Corticosteroids, propranolol, and vincristine have been used with minimal success, and only embolization and surgical resection have been shown to be definitive. 9,13,14 We present a rare, and sadly lethal, case of a neonate with a large CH and severe, overwhelming coagulopathy and multiorgan failure.Treatment options, which were carefully weighed for our patient, are

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Catastrophic congenital hemangioma with severe coagulopathy leading to fatal cardiac failure: Case report and review

Cohen‐Cutler

Szymanski

Bockoven

et al. 2021

Pediatric Dermatology

View full text Add to dashboard Cite

show abstract

“…There have been a few reports regarding the beneficial effect of propranolol, a non-selective β-blocker, in the treatment of GSD due to its antiangiogenic activity [13][14][15]. Atenolol was chosen in this case based on recent studies supporting its efficacy and safety over propranolol for infantile hemangiomas [16,17]. Four months after the triple combination therapy with pamidronate, sirolimus, and atenolol, a follow-up whole-body MRI was performed.…”

Section: Case Reportmentioning

confidence: 99%

Case Report and Literature Review: Bisphosphonate, Sirolimus, and Atenolol Treatment in a 4-Year-Old Child Diagnosed with Gorham–Stout Disease

Park,

Yoo,

Ahn

2023

Pharmaceuticals

View full text Add to dashboard Cite

We report a 4-year-old with Gorham–Stout disease (GSD) who was treated with a combination of bisphosphonate, sirolimus, and atenolol. A previously healthy 4-year-old girl presented with back pain after falling on her back 2 months prior. Thoracolumbar spine X-ray revealed diffuse compression spinal fractures in T9-L2. Magnetic resonance imaging (MRI) confirmed multiple compression fractures at T9-L5 and revealed a paraspinal mass along the T1-L1 level. Based on clinical, radiological, and histopathological findings, Gorham–Stout disease was diagnosed. Treatment with sirolimus (0.5 mg twice daily, 1.6 mg/m2) was initiated and intravenous bisphosphonate (pamidronate, 1 mg/kg for 3 days, total 3 mg/kg every 4 months) was added for back pain; she had immediate improvement in back pain. After 9 months with this treatment, she had a mild increase in paraspinal lymphangiomatosis and aggravation in T9-L5 compression fractures; atenolol was administered. The patient underwent 11 months of combination treatment with bisphosphonate, sirolimus, and atenolol, and MRI showed mild degree of reduction in the paraspinal lesions at L1-L5. The patient is currently in stable condition with no back pain or side effects. The triple combination treatment with bisphosphonate, sirolimus, and atenolol may be helpful in stabilizing the disease course of GSD.

show abstract

“…Several small studies have shown that atenolol and nadolol, selective beta-adrenergic receptor antagonists, are equally effective to propranolol. They may cause fewer side effects than propranolol, but the incidence of severe side effects does not differ 114–119…”

Section: Treatmentmentioning

confidence: 99%

“…They may cause fewer side effects than propranolol, but the incidence of severe side effects does not differ. [114][115][116][117][118][119] IH can sometimes ulcerate and/or bleed. The presence of a scab signifies ulceration.…”

Section: Treatmentmentioning

confidence: 99%

Infantile Hemangioma: A Current Review

Pahl

McLean

2021

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

Infantile hemangiomas (IHs) are common vascular lesions which are benign but can cause significant functional and cosmetic morbidity. Since the fortuitous discovery of propranolol being effective to treat IH over a decade ago, the therapy and prognosis for children with IH have improved dramatically. Oral propranolol (as well as other oral beta-blockers and topical timolol) are safe and effective treatments, and have now supplanted other therapies. Making the correct diagnosis is crucial, because other vascular lesions can mimic IH. In addition, IH can be the first manifestation of an underlying syndrome. For IH requiring treatment, initiating treatment early is key to optimizing success. Therefore, early recognition and referral, if necessary, are important. Continued research on IH, both basic science and clinical, should result in continued advances.

show abstract

Clinical evaluation of infantile hemangiomas treated with atenolol

Cited by 3 publications

References 0 publications

Catastrophic congenital hemangioma with severe coagulopathy leading to fatal cardiac failure: Case report and review

Catastrophic congenital hemangioma with severe coagulopathy leading to fatal cardiac failure: Case report and review

Case Report and Literature Review: Bisphosphonate, Sirolimus, and Atenolol Treatment in a 4-Year-Old Child Diagnosed with Gorham–Stout Disease

Infantile Hemangioma: A Current Review

Contact Info

Product

Resources

About