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Multifocal infantile haemangioma: a diagnostic challenge
Erica Torres1, João Rosa1, Christine Leaute-Labreze2
1Serviço de Pediatria, Hospital Faro, Centro Hospitalar Algarve, Faro, Portugal.
BMJ Case Reports
|June 19, 2016
Summary
This case study details a rare multifocal infantile hemangioma in a newborn, presenting with skin lesions and thrombocytopenia. Oral propranolol effectively treated the condition, leading to complete involution of skin and hepatic hemangiomas.
Area of Science:
- Pediatric Dermatology
- Vascular Anomalies
Background:
- Infantile hemangiomas (IHs) are common benign vascular tumors in infants.
- Multifocal IHs are less common and can present with systemic involvement.
- Early diagnosis and management are crucial for favorable outcomes.
Observation:
- A newborn presented with multiple cutaneous macules and papules, accompanied by thrombocytopenia.
- Abdominal ultrasound revealed hyperechoic papules and nodules.
- Skin biopsy confirmed infantile hemangioma via positive staining for glucose transporter 1 (GLUT1).
Findings:
- The patient developed gastrointestinal bleeding and anemia, despite negative endoscopic findings for intestinal hemangiomas.
- Treatment with oral propranolol (3 mg/kg/day) initiated at 2 months of age.
- Complete involution of skin and hepatic hemangiomas was observed by 15 months of age.
Implications:
- This case highlights a rare presentation of multifocal infantile hemangioma with hepatic and potential intestinal involvement.
- Oral propranolol demonstrates efficacy in treating complex infantile hemangiomas.
- Successful propranolol therapy underscores its role in managing challenging vascular anomalies in infants.
