Hemangioma medical therapy: Difference between revisions
Jump to navigation
Jump to search
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{Hemangioma}} | {{Hemangioma}} | ||
{{CMG}};{{AE}} {{NM}} | {{CMG}};{{AE}} {{NM}}{{ADS}} | ||
==Overview== | ==Overview== | ||
The majority of cases of hemangioma are self-limited. Patients with small, stable hemangiomas in non-vital sites are treated with "wait and see" approach, whereas patients with fast growth of hemangioma are treated medically.<ref name="epidemiology">Zheng JW, Zhang L, Zhou Q, et al. A practical guide to treatment of infantile hemangiomas of the head and neck. Int J Clin Exp Med. 2013;6(10):851-60.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832322/?report=classic#</ref> | The majority of cases of hemangioma are self-limited. Patients with small, stable hemangiomas in non-vital sites are treated with "wait and see" approach, whereas patients with fast growth of hemangioma are treated medically.<ref name="epidemiology">Zheng JW, Zhang L, Zhou Q, et al. A practical guide to treatment of infantile hemangiomas of the head and neck. Int J Clin Exp Med. 2013;6(10):851-60.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832322/?report=classic#</ref> | ||
| Line 31: | Line 31: | ||
'''Beyond proliferative phase''' | '''Beyond proliferative phase''' | ||
*Oral regimen | *Oral regimen | ||
** Preferred regimen (1): [[Propranolol]] 1.5-3 mg/kg/day PO for 8 months | ** Preferred regimen (1): [[Propranolol]] 1.5-3 mg/kg/day PO for 8 months.<ref name="pmid21362031">{{cite journal |vauthors=Zvulunov A, McCuaig C, Frieden IJ, Mancini AJ, Puttgen KB, Dohil M, Fischer G, Powell J, Cohen B, Ben Amitai D |title=Oral propranolol therapy for infantile hemangiomas beyond the proliferation phase: a multicenter retrospective study |journal=Pediatr Dermatol |volume=28 |issue=2 |pages=94–8 |date=2011 |pmid=21362031 |doi=10.1111/j.1525-1470.2010.01379.x |url=}}</ref> | ||
==References== | ==References== | ||
Revision as of 19:49, 26 October 2018
|
Hemangioma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Hemangioma medical therapy On the Web |
|
American Roentgen Ray Society Images of Hemangioma medical therapy |
|
Risk calculators and risk factors for Hemangioma medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]Amandeep Singh M.D.[3]
Overview
The majority of cases of hemangioma are self-limited. Patients with small, stable hemangiomas in non-vital sites are treated with "wait and see" approach, whereas patients with fast growth of hemangioma are treated medically.[1]
Medical Therapy
- Medical and surgical options are available for the treatment of “problematic” hemangiomas.[2]
- Medical management includes one or more systemic therapies.
- For massive and life-threatening disease:[2]
- These agents have also been used for:[2]
- Multifocal disease
- Visceral involvement
- Segmental distribution
- Airway obstruction
- Periorbital lesions
Propranolol
- A paradigm shift has occurred regarding the treatment of hemangiomas over the past few years.[2]
- Propranolol, a nonselective β-adrenergic antagonist, was serendipitously discovered to cause regression of proliferating hemangiomas in newborns receiving treatment for cardiovascular disease.
- Numerous studies demonstrating the success of propranolol for shrinking hemangiomas
- Over ninety percent of patients have dramatic reduction in the size of their hemangiomas as early as 1-2 weeks following the first dose of propranolol.
- Dosing for propranolol in treating hemangiomas is recommended to be 2-3 mg/kg separated into two or three-times-a-day regimens.
- These doses are dramatically below the concentration employed for cardiovascular conditions in children.[2]
Pediatric/Infantile hemangioma in proliferative phase:
- Oral regimen
- Preferred regimen (1): Propranolol 0.5 mL/kg PO q12h for 7 days;
- Propranolol 0.3 mL/kg PO q12h for 7 days;
- Propranolol 0.4 mL/kg PO q12h for 6 months
- Preferred regimen (1): Propranolol 0.5 mL/kg PO q12h for 7 days;
Beyond proliferative phase
- Oral regimen
- Preferred regimen (1): Propranolol 1.5-3 mg/kg/day PO for 8 months.[3]
References
- ↑ Zheng JW, Zhang L, Zhou Q, et al. A practical guide to treatment of infantile hemangiomas of the head and neck. Int J Clin Exp Med. 2013;6(10):851-60.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832322/?report=classic#
- ↑ 2.0 2.1 2.2 2.3 2.4 Richter, Gresham T.; Friedman, Adva B. (2012). "Hemangiomas and Vascular Malformations: Current Theory and Management". International Journal of Pediatrics. 2012: 1–10. doi:10.1155/2012/645678. ISSN 1687-9740.
- ↑ Zvulunov A, McCuaig C, Frieden IJ, Mancini AJ, Puttgen KB, Dohil M, Fischer G, Powell J, Cohen B, Ben Amitai D (2011). "Oral propranolol therapy for infantile hemangiomas beyond the proliferation phase: a multicenter retrospective study". Pediatr Dermatol. 28 (2): 94–8. doi:10.1111/j.1525-1470.2010.01379.x. PMID 21362031.