Neutrophilic figurate erythema of infancy associated with juvenile myelomonocytic leukemia / Eritema figurado neutrofílico de la infancia asociado a Leucemia Mielomonocítica Juvenil

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Propranolol oral en el Tratamiento de los Hemangiomas de la Infancia: Serie de 57 pacientes / Oral Propranolol for Treating Infantile Hemangiomas: A Case Series of 57 Patients

Introducción y objetivos: Los hemangiomas de la infancia (HI) son un tumor vascular frecuente. En los últimos años, el propranolol ha demostrado ser una alternativa terapéutica para los HI. El objetivo del presente estudio fue evaluar la efectividad del propranolol para losHI. Material y método: Lo pacientes que requirieron tratamiento de sus HI fueron incluidos. Se realizó evaluación por cardiología infantil en todos los pacientes. Se inició propranolol a una dosis de 2 mg/kg al día dividas en dos tomas. A los 10 días de tratamiento se realizó Holter de arritmias de 24 horas a todos los pacientes. Evaluación de efectividad: se realizó formalmente en todos los controles clínicos y mediante iconografía, sin ciego. La respuesta se clasificó en respuesta complete (RC), respuesta parcial (RP) y no respuesta (NR). Los efectos adversos se registraron en un formulario especialmente diseñado. Resultados: Se incluyeron 57 pacientes. La edad promedio al inicio fue de 9,7 meses. 80,8% fueron mujeres; la duración del tratamiento promedio fue de 7,3 meses (rango 1-24 meses). Eficacia: se obtuvo 50,6% de RC y 49,3% de RP. No hubo diferencia al analizar la respuesta a tratamiento de acuerdo a la ubicación y a la edad. Hubo un 7% de eventos adversos sin haber ningún Holter alterado a los 10 días. Conclusiones: Nuestro estudio destaca la posibilidad de iniciar propranolol de forma ambulatoria, establece una dosis de 2 mg/kg al día y confirma el perfil de seguridad del fármaco. Nosotros consideramos propranolol el fármaco de primea línea en el tratamiento de HI; en los casos en que sea necesario el tratamiento de estas lesiones (AU)

Introduction and objectives: Infantile hemangiomas (IH) are a frequent vascular tumor. In recent years, propranolol has emerged as an alternative in the treatment of IH. The objective of the present study was to evaluate the effectiveness of propranolol for the treatment ofIH. Materials and methods: Patients with IH requiring treatment were included. Cardiologic evaluation was made to every patient and electrocardiogram (ECG) and echocardiogram were done. Oral propranolol was started in an ambulatory way at a dose of 2 mg/kg daily divided in two doses. At ten days all the patients were evaluated with a 24-h rhythm holter. Evaluation of effectiveness: In clinical controls and by images IH were formally analyzed, without blindness. Response was categorized as complete response (CR), partial response (PR) and no response (NR). Adverse events: Adverse events were registered in a special category of the formulary. Results: 57 patients were included. Mean age was 9.7 months. There were 80.8% females. Mean duration of treatment was 7.3 months (1-24 months). Efficacy: 50.6% had CR, 49.3% had PR. There were a 7% of adverse events. No differences in response rate exist according to age or location. No rhythm holter was altered at ten-day control. Conclusion: Our study highlights the possibility of starting propranolol in an ambulatory way, establishes a dose of 2 mg/kg/day and confirms the security profile of the drug. We consider propranolol as a first line treatment for IH (AU)

Oral propranolol for treating infantile hemangiomas: a case series of 57 patients.

INTRODUCTION AND OBJECTIVES: Infantile hemangiomas (IH) are a frequent vascular tumor. In recent years, propranolol has emerged as an alternative in the treatment of IH. The objective of the present study was to evaluate the effectiveness of propranolol for the treatment of IH. MATERIALS AND METHODS: Patients with IH requiring treatment were included. Cardiologic evaluation was made to every patient and electrocardiogram (ECG) and echocardiogram were done. Oral propranolol was started in an ambulatory way at a dose of 2mg/kg daily divided in two doses. At ten days all the patients were evaluated with a 24-h rhythm holter. Evaluation of effectiveness: In clinical controls and by images IH were formally analyzed, without blindness. Response was categorized as complete response (CR), partial response (PR) and no response (NR). Adverse events: Adverse events were registered in a special category of the formulary. RESULTS: 57 patients were included. Mean age was 9.7 months. There were 80.8% females. Mean duration of treatment was 7.3 months (1-24 months). EFFICACY: 50.6% had CR, 49.3% had PR. There were a 7% of adverse events. No differences in response rate exist according to age or location. No rhythm holter was altered at ten-day control. CONCLUSION: Our study highlights the possibility of starting propranolol in an ambulatory way, establishes a dose of 2mg/kg/day and confirms the security profile of the drug. We consider propranolol as a first line treatment for IH.