Adverse effects of propranolol treatment for infantile hemangiomas in China

The β-blocker propranolol was discovered to be highly effective for the treatment of infantile hemangiomas (IHs), since 2008. Although some side effects have been reported earlier, no serious side effects of its use have been reported so far in Asia, especially in China. To determine the safety of this therapy, the side effects were analyzed in 97 infants who used propranolol (2 mg kg(-1)·d(-1)) against hemangioma from 2010 to 2011.

Routine blood and urine tests, hepatic and renal function tests, myocardial enzyme, electrolytes and blood sugar levels at baseline were performed. Electrocardiogram monitoring was performed 48 h after administration of the first dose (2 mg kg(-1)·d(-1)). Every patient (n = 97) was required to report to the hospital once a month.

The following adverse effects were observed: bronchial hyperactivity (n = 5), cyanosis and cold extremities (n = 1), agranulocytosis (n = 1), and low body temperature (n = 1). These side effects were reported for the first time in Asia.

Although propranolol is effective against IHs, its potential side effects should be considered and appropriate monitoring performed. Further studies need to be conducted to determine the optimal dose and duration of propranolol treatment for large and complex hemangiomas.