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      Hemangioma cráneo-facio-cervical y subglótico con clínica respiratoria. Una urgencia terapéutica Translated title: Cranio-facial-cervical and subglottic hemangioma with respiratory symptoms. A therapeutic emergency

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          Abstract

          Resumen Se describe el caso de una lactante de 41 días de vida con un hemangioma cráneo-facio-cervical izquierdo y subglótico con repercusión respiratoria. Aunque los hemangiomas infantiles son tumores vasculares benignos que se presentan predominantemente en piel y de forma aislada, un 1-2% de los pacientes pueden tener lesiones en la vía aérea que ocasionalmente provocan cuadros respiratorios potencialmente mortales. Se decidió iniciar inmediatamente el tratamiento con propranolol, sin esperar a completar el diagnóstico de extensión y sindrómico, con buena respuesta clínica y desaparición de la sintomatología respiratoria en las siguientes doce horas. En los niños con hemangiomas que por su localización produzcan síntomas o alteración funcional importante, es imprescindible iniciar el tratamiento betabloqueante de forma precoz y en algunos casos, urgentemente.

          Translated abstract

          Abstract We describe the case of a 41-day-old infant with a left craniofacial cervical and subglottic hemangioma with respiratory symptoms. Although infantile hemangiomas are occasional benign vascular tumors that appear predominantly on the skin, 1-2% of patients may have airway lesions that can sometimes cause potentially life-threatening respiratory conditions. The decision was made to immediately commence treatment with propranolol, without waiting to complete the extension and syndromic diagnoses. There was a positive clinical response and respiratory symptoms dissipated in twelve hours. Early treatment with beta-blockers is essential for children with hemangiomas whose location causes symptoms or significant functional changes: in some cases it may be a matter of urgency.

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          Treatment of infantile haemangiomas: recommendations of a European expert group

          With a prevalence of 2.6-4.5 %, infantile haemangiomas (IH) represent the most common tumour of infancy. While the majority of IH does not require therapy and regresses spontaneously, about 10 % of IH exhibit complications such as obstruction, ulceration or disfigurement. With the advent of oral propranolol, many conventional treatment options have become obsolete. This paper summarizes current recommendations for management of complicated IH. These recommendations have been written by an expert group after a consensus process including bibliographic review, several drafts of synthesis, meetings with quantitative voting system and redaction of an approved final manuscript.
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            Role of Propranolol in the therapeutic strategy of infantile laryngotracheal hemangioma.

            There are recent reports of effective treatment of cutaneous hemangiomas with Propranolol. The current study aims to assess efficacy of systemic Propranolol for subglottic hemangiomas and to discuss its place among the other available therapies. We report 2 infants with subglottic hemangiomas, which were resistant to other established medical treatments. One infant presented with PHACES association, the other with widespread cutaneous congenital hemangiomas. Both were subsequently treated with systemic Propranolol. Both patients' subglottic hemangiomas responded dramatically to systemic Propranolol. No side effects of the therapy occurred, and a safety protocol previously designed for Propranolol prescribed for other indications was applied to our patients. Propranolol appears to be an effective treatment for subglottic hemangiomas and should now be used as a first-line treatment in subglottic hemangiomas when intervention is required.
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              Oral propranolol in the treatment of proliferating infantile haemangiomas: British Society for Paediatric Dermatology consensus guidelines.

              Infantile haemangiomas (IH) are the most common vascular tumours of infancy. Despite their frequency and potential complications, there are currently no unified U.K. guidelines for the treatment of IH with propranolol. There are still uncertainties and diverse opinions regarding indications, pretreatment investigations, its use in PHACES (posterior fossa malformations-haemangiomas-arterial anomalies-cardiac defects-eye abnormalities-sternal cleft and supraumbilical raphe) syndrome and cessation of treatment.
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                Author and article information

                Journal
                asisna
                Anales del Sistema Sanitario de Navarra
                Anales Sis San Navarra
                Gobierno de Navarra. Departamento de Salud (Pamplona, Navarra, Spain )
                1137-6627
                April 2021
                : 44
                : 1
                : 113-117
                Affiliations
                [2] Pamplona orgnameComplejo Hospitalario de Navarra orgdiv1Otorrinolaringología Pediátrica España
                [1] Pamplona orgnameComplejo Hospitalario de Navarra orgdiv1Cirugía Pediátrica España
                Article
                S1137-66272021000100011 S1137-6627(21)04400100011
                10.23938/assn.0929
                3eb3726e-a655-434f-9b90-4e75924dd952

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 30 September 2020
                : 07 November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 5
                Product

                SciELO Spain

                Categories
                Notas Clínicas

                Propranolol,Stridor,Hemangioma subglótico,Estridor,Subglottic hemangioma

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