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Severe hypoglycemia during successful treatment of diffuse hemangiomatosis with propranolol

Ernesto Bonifazi1, Angelo Acquafredda, Antonella Milano

  • 1Pediatric Dermatology Unit, University of Bari, Bari, Italy. ejpd@dermatologiapediatrica.com

Pediatric Dermatology
|June 12, 2010
PubMed

Insights

Oral propranolol effectively treated infantile hemangiomas but can cause hypoglycemia, a dangerous side effect. Vigilance for low blood sugar is crucial in infants receiving propranolol, especially with reduced caloric intake.

Area of Science:

  • Pediatric Pharmacology
  • Dermatology
  • Neonatology

Background:

  • Infantile hemangiomas are common benign vascular tumors.
  • Propranolol is a first-line treatment for problematic infantile hemangiomas.
  • Potential adverse effects of propranolol in infants require careful monitoring.

Observation:

  • A 27-day-old infant with diffuse hemangiomatosis received oral propranolol.
  • Significant regression of skin and liver hemangiomas was observed.
  • The infant later experienced seizures associated with hypoglycemia and increased ketone bodies.

Findings:

  • Hypoglycemia (low blood glucose) is a significant and often unrecognized side effect of propranolol therapy.
  • This adverse event is more likely in infants with decreased oral intake.
  • Prompt recognition and management of hypoglycemia are essential.

Implications:

  • Increased clinical vigilance for hypoglycemia is recommended in infants on chronic propranolol treatment, particularly those with diminished caloric intake.
  • This case highlights the importance of monitoring blood glucose levels in infants receiving propranolol.
  • Early detection and intervention can prevent severe complications associated with hypoglycemia.

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