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Adverse effects of systemic glucocorticosteroid therapy in infants with hemangiomas

Manju E George1, Vidya Sharma, Jill Jacobson

  • 1Section of Dermatology, Children's Mercy Hospital, Kansas City, MO, USA. mgeorge@kumc.edu

Archives of Dermatology
|August 18, 2004
PubMed

Insights

Systemic glucocorticosteroids (GS) for infantile hemangiomas can cause behavioral changes and gastrointestinal issues. Long-term use frequently leads to hypertension and adrenal suppression, requiring careful infant monitoring.

Area of Science:

  • Pediatric Dermatology
  • Neonatal Medicine
  • Pharmacology

Background:

  • Infantile hemangiomas are common vascular tumors in infants.
  • Systemic glucocorticosteroids (GS) are a primary treatment for problematic hemangiomas.
  • Evaluating the safety profile of GS therapy in this population is crucial.

Purpose of the Study:

  • To assess the short- and long-term adverse effects of systemic glucocorticosteroid (GS) therapy in infants diagnosed with hemangiomas.
  • To identify common complications and monitor physiological changes associated with GS treatment.

Main Methods:

  • Retrospective chart review of 22 infants treated with GS for hemangiomas over a 3-year period.
  • Analysis included demographic data, GS dosage and duration, parental concerns, hemangioma complications, and hormonal assessments (cortisol levels, corticotropin stimulation tests).

Main Results:

  • Common parental concerns included irritability, fussiness, and insomnia (73%).
  • Hypertension was observed in 45% of patients.
  • Adrenal suppression was frequent, with abnormal morning cortisol levels in 87% and abnormal corticotropin stimulation tests in 2 of 3 infants.

Conclusions:

  • Systemic glucocorticosteroid therapy for infantile hemangiomas is generally tolerated but associated with significant adverse effects.
  • Hypertension and hypothalamic-pituitary-adrenal axis suppression are common findings.
  • Close monitoring for these adverse effects is recommended for infants receiving long-term GS treatment.
Abstract

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