VISCERAL HEMANGIOMAS IN CHILDREN: CLINICAL FEATURES, COMPLICATIONS, AND TREATMENT OPTIONS.
DOI:
https://doi.org/10.11603/24116-4944.2016.2.6829Keywords:
hepatic hemangiomas, airway hemangiomas, propranolol.Abstract
Airway and hepatic hemangiomas (HH) may have severe clinical manifestations and accompanied by life-threatening complications. The aim of the work was to estimate the clinical signs, risk factors, complications and treatment options of AH and HH. The study enrolled 16 children aged 1–12 months during 2011–2015. AH was diagnosed in 7, HH – in 8 children. Diagnosis of AH was established by tracheobronchoscopy, CT with contrast, and MRI. For HH diagnostic methods were ultrasound, CT with contrast and MRI. There are three types of HH: focal, multifocal, and diffuse. 14 patients received propranolol in dose of 2 mg/kg/day. In patient with focal HH performed only observation. AH is accompanied by face segmental hemangiomas in 42.3 %, all patients with multifocal HH have multiple skin infantile hemangiomas (IHs). Clinical signs of AH documented in average age 4.2 months (range, 2–5 months). Among HH 62.5 % were focal, 25.0 % multifocal, and 12.5 % diffuse. Diffuse HH clinically manifested immediately after birth with signs of liver failure and hypothyroidism. Treatment of AH starts immediately after diagnosis, in the age range 2.5–4.5 months, except one 12 month patient with late diagnosis. Average treatment duration was 16.1 months. In children with multifocal HH treatment starts in age 2–5 months. In children with diffuse HH propranolol treatment starts in 14 and 20 days. The duration of treatment of liver hemangiomas is an average of 10.1 months. Treatment with propranolol was effective, involution of the tumor occurred in all patients. We have not any complications. AH is accompanied by segmental face hemangiomas, multifocal HH are combined with multiple skins IHs. Diffuse HH complicated by liver failure and hypothyroidism. Nonselective beta-blocker propranolol is effective in treating hepatic and airway hemangiomas.References
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