CLINICAL CASE OF TREATMENT OF HEPATIC HAEMANGIOMA BY PROPRANOLOL IN THE NEWBORN

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Abstract

Clinical observation of conservative treatment of the left hemi-liver haemangioma by propranolol in the full-term newborn with initial symptoms of cardiac failure is presented. Extensive hepatic haemangioma was diagnosed prenatally on the 23–24th week of a gestation. After the birth the clinical diagnosis was confirmed by means of ultrasound investigation (the size — 50×30 mm) and by the data of computer tomography. The starter dose of propranolol made 0.5 mg/kg per day with further increase to 1,5 mg/kg per day; the preparation was prescripted at the age of 2 days of life. Episodes of decrease in cardiac rate to 95 b/min are noted among side effects. The child was dismissed for out-patient observation at the age of 12 days of life in a stable state. The positive dynamics is registered during ultrasound investigation in 6 months after initiation of treatment: lesion was significantly decreased in the size, and there was a considerable decrease in a blood flow. Treatment by propranolol in a dose of 1,5 mg/kg per day was continued. Modern data on possible mechanisms of propranolol effect at haemangiomas in children, regimen, side effects and complications are provided in discussion. It is noted that this drug can be considered as the agent of choice in the treatment of infantile haemangiomas in children of difficult localization since the neonatality period.

About the authors

Yu. I. Kucherov

Scientific Centre of Children's Health, Moscow
Pirogov Russian National Research Medical University, Moscow

Author for correspondence.
Email: ykucherov@mail.ru
PhD, professor, Head of the Department of Premature Surgery and Intensive Care of RI of Pediatric Surgery of SCCH, professor of the Department of Pediatric Surgery of N.I. Pirogov Russian National Research Medical University Russian Federation

Yu. V. Zhirkova

N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation

Email: zhirkova@mail.ru
PhD, chief research scientist of the Department of Premature Surgery and Intensive Care of RI of Pediatric Surgery of SCCH, professor of the Department of Pediatric Anaesthesiology and Intensive Care of Faculty of advanced medical studies of N.I. Pirogov Russian National Research Medical University. Address: build. 1, 2, Lomonosovskii Avenue, Moscow, RF, 119991; tel.: +7 (499) 134-09-08 Russian Federation

A. N. Getman

Scientific Centre of Children's Health, Moscow, Russian Federation

Email: getman@nczd.ru
MD, Head of the Department of Computer tomography of X-ray diagnostics of Consultation-diagnostic center of SCCH. Address: build. 1, 2, Lomonosovskii Avenue, Moscow, RF, 119991; tel.: +7 (499) 134-10-65 Russian Federation

S. A. Ivleva

Scientific Centre of Children's Health, Moscow, Russian Federation

Email: ivlevasu@gmail.com
junior research scientist of the Department of Suprasonic Diagnostics of RI of Pediatrics of SCCH. Address: build. 1, 2, Lomonosovskii Avenue, Moscow, RF, 119991; tel.: +7 (499) 162-26-01 Russian Federation

M. G. Rekhviashvili

Scientific Centre of Children's Health, Moscow, Russian Federation

Email: m.rekhviashvili@bk.ru

resident physician of SCCH. Address: build. 1, 2, Lomonosovskii Avenue, Moscow, RF, 119991; tel.: +7 (499) 134-09-08

Russian Federation

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