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A New Perspective for Infantile Hepatic Hemangioma in the Age of Propranolol: Experience at Baskent University.

Abstract
Propranolol was first used in 2008 to treat hemangioma; its efficacy and safety have since changed the classical treatment indications. Infantile hepatic hemangioma presents as a spectrum of clinical conditions varying from simple asymptomatic lesions to lethal complications. Tufted hemangioma and Kaposiform hemangioendothelioma are congenital vascular tumors that lead to Kasabach-Merritt syndrome. Hemangiomas, like pure arteriovenous malformations, can cause hyperdynamic heart failure, and diffuse nodular-type hemangiomas can present with hypothyroidism. Respiratory problems and hepatic failure can be associated with diffuse nodular-type liver hemangiomas. There is a spectrum of approaches to management, varying from "watchful waiting" to liver transplant. In the age of propranolol, there has been a prominent change in the infantile hepatic hemangioma treatment algorithm. Our suggestion is early treatment with 3 mg/kg/day propranolol plus 1.0 to1.5 mg/kg/day prednisolone in all patients. This protocol is the most effective strategy for type 3 infantile hepatic hemangioma. Approximately one-third of patients with abdominal compartment syndrome in the era before propranolol treatment required liver transplant; this new treatment obviates transplant for many of these patients.
AuthorsFaik Sarıalioğlu, Nalan Yazıcı, Ayşe Erbay, Fatih Boyvat, Şenay Demir, Figen Özçay, Nihal Uslu
JournalExperimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation (Exp Clin Transplant) Vol. 15 Issue Suppl 2 Pg. 74-78 (Mar 2017) ISSN: 2146-8427 [Electronic] Turkey
PMID28302004 (Publication Type: Journal Article)
Chemical References
  • Prednisolone
  • Propranolol
Topics
  • Age of Onset
  • Algorithms
  • Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
  • Critical Pathways
  • Female
  • Hemangioma (drug therapy, pathology)
  • Humans
  • Infant
  • Liver Neoplasms (drug therapy, pathology)
  • Liver Transplantation
  • Male
  • Prednisolone (therapeutic use)
  • Propranolol (adverse effects, therapeutic use)
  • Retrospective Studies
  • Treatment Outcome
  • Turkey
  • Universities

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