Marco Pensabene, Chiara Cambiaso, Maria Patti, Maria Sergio, Gregorio Serra, Francesco Grasso, Fabio Baldanza, Mario Giuffre', Giovanni Corsello, Maria Rita Di Pace
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引用次数: 0
Abstract
Background: Infantile hemangiomas (IH) are the most common benign vascular tumors in neonates, with a prevalence of 5-10% in full-term infants. Its occurrence in the palate is rare. While typically self-limiting, complicated IHs can lead to significant morbidity, especially when involving critical structures.
Case presentation: We report the case of a full-term newborn presenting with a 2×2 cm exophytic lesion on the hard palate, causing feeding difficulties, anemia, and recurrent bleeding. Early administration of oral propranolol, initiated on the 11th day of life, proved effective in managing this complicated IH. The treatment, started at a dose of 0.5 mg/kg/day and gradually increased to 3 mg/kg/day, resulted in rapid ulceration healing and lesion regression. Follow-up over eight months confirmed the therapy's efficacy and safety, with no adverse effects reported. To contextualize this case, a systematic review of the literature was conducted following PRISMA guidelines, focusing on neonatal IHs of the head and neck treated with beta-blockers. Out of 1052 papers identified between 2015 and 2024, only four relevant studies were included. These cases highlighted propranolol's role as a first-line treatment for complicated IHs, even in neonates. However, the review also emphasized diagnostic challenges, particularly in atypical locations such as the hard palate, which may delay therapy.
Conclusions: This case and literature review underscore the importance of early diagnosis and a multidisciplinary approach for managing high-risk IHs. While propranolol is generally avoided in neonates younger than 45 weeks of corrected gestational age due to potential adverse effects, our findings suggest that close monitoring in a hospital setting enables its safe administration. This report contributes to the growing evidence supporting propranolol as a safe and effective therapy for neonatal IHs and highlights the need for further research to refine treatment protocols for this vulnerable population.
期刊介绍:
Italian Journal of Pediatrics is an open access peer-reviewed journal that includes all aspects of pediatric medicine. The journal also covers health service and public health research that addresses primary care issues.
The journal provides a high-quality forum for pediatricians and other healthcare professionals to report and discuss up-to-the-minute research and expert reviews in the field of pediatric medicine. The journal will continue to develop the range of articles published to enable this invaluable resource to stay at the forefront of the field.
Italian Journal of Pediatrics, which commenced in 1975 as Rivista Italiana di Pediatria, provides a high-quality forum for pediatricians and other healthcare professionals to report and discuss up-to-the-minute research and expert reviews in the field of pediatric medicine. The journal will continue to develop the range of articles published to enable this invaluable resource to stay at the forefront of the field.