Complicated Infantile Hemangiomas in the palate: case report of a newborn patient and review of the literature.

IF 3.2 3区 医学 Q1 PEDIATRICS
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.

复杂的婴儿腭裂血管瘤:新生儿1例报告及文献复习。
背景:婴儿血管瘤(IH)是新生儿最常见的良性血管肿瘤,在足月婴儿中患病率为5-10%。它发生在上颚是罕见的。虽然通常是自限性的,但复杂的his可导致显著的发病率,特别是当涉及关键结构时。病例介绍:我们报告的情况下,足月新生儿表现为2×2厘米外生性病变的硬腭,造成喂养困难,贫血,和复发性出血。事实证明,在出生第11天开始口服心得安对治疗这种复杂的IH是有效的。治疗开始剂量为0.5 mg/kg/天,逐渐增加到3mg /kg/天,导致溃疡快速愈合和病变消退。8个多月的随访证实了该疗法的有效性和安全性,无不良反应报告。为了了解本病例的背景,根据PRISMA指南对文献进行了系统的回顾,重点是用β受体阻滞剂治疗的新生儿头颈部IHs。在2015年至2024年间确定的1052篇论文中,只有4篇相关研究被纳入其中。这些病例强调了心得安作为复杂his的一线治疗药物的作用,即使对新生儿也是如此。然而,该综述也强调了诊断方面的挑战,特别是在非典型部位,如硬腭,这可能会延迟治疗。结论:本病例和文献综述强调了早期诊断和多学科方法管理高危IHs的重要性。虽然由于潜在的不良反应,小于45周的准胎龄的新生儿通常避免使用心得安,但我们的研究结果表明,在医院环境中密切监测可以确保其安全使用。该报告为越来越多的证据支持心得安是一种安全有效的新生儿IHs治疗提供了帮助,并强调需要进一步研究以完善针对这一弱势群体的治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.10
自引率
13.90%
发文量
192
审稿时长
6-12 weeks
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.
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