Temperature Instability in an Infant Treated with Propranolol for Infantile Hemangioma

Area of Science:

• Pediatrics
• Dermatology
• Pharmacology

Background:

• Infantile hemangiomas are common vascular tumors in infants.
• Treatment options include surgery, laser, and medications like propranolol.
• Propranolol is the sole FDA-approved medication for infantile hemangiomas.

Observation:

• A preterm infant with multiple infantile hemangiomas experienced temperature instability while on propranolol.
• The infant required incubator support, which could not be discontinued during propranolol treatment.
• Discontinuation of propranolol led to the resolution of temperature instability.

Findings:

• Propranolol, a nonselective beta-blocker, may cause adverse effects on thermoregulation in preterm infants.
• Atenolol, a cardioselective beta-blocker, was successfully used to treat infantile hemangiomas without affecting the infant's temperature regulation.
• This suggests atenolol may be a safer alternative for managing infantile hemangiomas in infants with temperature instability.

Implications:

• Clinicians should monitor preterm infants for temperature instability during propranolol therapy.
• Atenolol presents a potential alternative treatment for infantile hemangiomas, particularly in vulnerable infants.
• Further research is warranted to confirm the safety and efficacy of atenolol in this population.