[Clinical case of treatment of hepatic haemangioma by propranolol in the newborn]

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 prenataly on the 23-24th week of a gestation. After the birth the clinical diagnosis was confirmed by means of ultrasound investigation (the size--50 x 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.