[Hypertrophic cardiomyopathy associated with oral corticosteroid therapy for palpebral hemangioma]

Area of Science:

• Pediatric Dermatology
• Cardiology
• Pharmacology

Background:

• Systemic corticosteroid therapy is a standard treatment for infantile hemangioma, particularly when vascular complications are a risk.
• While generally well-tolerated, potential adverse effects require careful consideration.

Observation:

• A two-month-old infant with a rapidly developing lower eyelid hemangioma was treated with betamethasone (0.3 mg/kg/day) to prevent vision impairment.
• Treatment was effective for the hemangioma, but a systolic cardiac murmur was detected.
• Cardiac sonography revealed obstructive hypertrophic cardiomyopathy, which regressed upon gradual corticosteroid dose reduction.

Findings:

• Systemic corticosteroid treatment for infantile hemangioma can be associated with the rare but serious adverse effect of cardiomyopathy.
• Cardiomyopathy induced by corticosteroids may be reversible with dose reduction or cessation of the medication.

Implications:

• Clinical and echocardiographic monitoring are crucial for infants receiving systemic corticosteroids for hemangioma, especially if cardiac abnormalities are suspected.
• Early detection of cardiac murmurs and prompt cardiac evaluation are vital to manage potential corticosteroid-induced cardiomyopathy.