Evolving strategy in treatment of infantile hemangiomas: from steroids to propranolol

Year 2016, Volume: 41 Issue: 2, 354 - 359, 30.06.2016

Serhan Küpeli

https://doi.org/10.17826/cutf.201781

Cited By: 2

Abstract

Infantile hemangiomas are the most common vascular tumors of the early childhood. Increased incidence of infantile hemangiomas can be attributed to widespread use of assisted reproductive technologies. Majority of hemangiomas in infantile age group resolve spontaneously and only a small proportion of the cases with infantile hemangiomas requires treatment. GLUT-ONE acronym (Giant infantile hemangiomas, Liver and/or other visceral organ involvement, Ulcerated or bleeding infantile hemangiomas, Threatening of life, Organ dysfunctioning infantile hemangiomas, Non-localized infantile hemangiomas, Esthetic/cosmetic compromise) can help clinicians for the rapid decision of treatment. Corticosteroids have long been the mainstay treatment for hemangiomatous lesions but after the description of antiproliferative effect of propranolol on severe infantile hemangiomas in 2008, propranolol has been the preferred choice of treatment in many centers. Future studies should be directed to answer the questions regarding the optimal duration of propranolol treatment to overcome recurrences and clinical and histopathological characteristics of infantile hemangiomas that failed treatment with propranolol.

Keywords

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İnfantil hemanjiyomlarda steroidlerden propranolole gelişen tedavi stratejisi

Abstract

İnfantil hemanjiyomlar erken çocukluk döneminde en sık görülen damarsal tümörlerdir. İnfantil hemanjiyomların insidansında görülen artıştan yardımcı üreme tekniklerinin yaygın olarak kullanılmaya başlanması da sorumlu tutulmaktadır. Çoğu infantil dönemde kendiliğinden gerilese de infantil hemanjiyomların küçük bir kısmı tedavi gerektirmektedir. Bu derlemede sunulan GLUT-ONE akrostişi (dev infantil hemanjiyomlar, karaciğer ve/veya iç organları tutan infantil hemanjiyomlar, ülsere veya kanamalı infantil hemanjiyomlar, yaşamı tehdit eden infantil hemanjiyomlar, organ disfonksiyonuna neden olan infantil hemanjiyomlar, lokalize olmayan infantil hemanjiyomlar, estetik/kozmetik bozukluğa neden olan infantil hemanjiyomlar) klinisyenlere tedavi endikasyonları konusunda yardımcı olabilecektir. Kortikosteroidler uzunca bir süreden beri tedavinin ana unsuru olsalar da 2008 yılında propranololün antiproliferatif etkisi tanımlandıktan sonra birçok merkezde propranolol infantil hemanjiyomların tedavisinde ilk tercih edilen ilaç olmuştur. Gelecekteki çalışmalar tedavi sonrasında rekürrensleri önlemek adına uygulanması gereken süre ve propranolol tedavisine yanıtsız infantil hemanjiyomların histopatolojik özellikleri gibi konulara odaklanmalıdır.

Keywords

İnfantil hemanjiyomlar, steroidler, propranolol, tedavi endikasyonları, glut-one

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