Effectiveness of Propranolol in a Newborn with Liver Hemangiomatosis

Introduction

Infantile hemangiomas (IH) are common in newborns (about 3%), with a higher incidence in low birth weight infants [1]. Disseminated forms with several hemangiomas (more than 5) in one individual are much rarer. They are classified as purely cutaneous hemangiomatosis, combined cutaneous and visceral hemangiomatosis or purely visceral hemangiomatosis. Segmental hemangiomas may also show associated visceral involvement [2]. Cutaneous forms are generally benign and regress spontaneously. Cases of visceral involvement with many liver arteriovenous fistulas may cause high output cardiac failure with life-threatening consequences. To treat progressive congestive heart failure, many therapies have been introduced: hepatic artery ligation (first report in 1967) [3] [4] [5], radiation therapy [6], partial liver resection [7], special compression sutures for affected liver tissue [8], arterial hepatic embolization [9], urgent liver transplantation [10] and various medical treatments with prednisone, interferon alpha 2a [11], cyclophosphamide [12] [13] [14] and vincristine [15]. In June 2008, 2 French groups from Montpellier and Bordeaux presented their first compelling results on the treatment of IH with a non-selective beta-blocker at the 17^th International Workshop of the International Society for the Study of Vascular Anomalies (ISSVA) in Boston [16]. We subsequently began to treat infants with IH in 2008 with encouraging results. In 2009 we introduced propranolol to treat a patient with liver hemangiomatosis.

References

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