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El hemangioma infantil
Christine Léauté-Labrèze1, John I Harper2, Peter H Hoeger3
1Department of Dematology, Pellegrin Children's Hospital, Bordeaux, France.
Lancet (London, England)
|January 17, 2017
Resumen
Los hemangiomas infantiles, tumores benignos infantiles comunes, a menudo se resuelven sin tratamiento. Se recomienda la intervención temprana con propranolol oral en los casos de alto riesgo para prevenir complicaciones.
Área de la Ciencia:
- Oncología pediátrica
- Dermatología
- Anomalías vasculares
Sus antecedentes:
- Los hemangiomas infantiles (IH) son los tumores benignos más comunes en la infancia, que afectan al 4,5% de los recién nacidos.
- Las hemorragias intestinales suelen crecer rápidamente en las primeras semanas de vida y luego involucionar espontáneamente.
- Si bien la mayoría de los IH no requieren tratamiento, algunos casos requieren intervención debido a los riesgos.
Objetivo del estudio:
- Para describir el manejo de los hemangiomas infantiles.
- Identificar los factores de riesgo y las indicaciones para el tratamiento de las EI.
- Para enfatizar el papel de la terapia temprana con propranolol.
Principales métodos:
- Revisión de la literatura actual y de las directrices clínicas para el tratamiento del hemangioma infantil.
- Identificación de los momentos críticos para el seguimiento del crecimiento de la IH.
- Evaluación de las indicaciones para el tratamiento y la eficacia del propranolol oral.
Principales resultados:
- El 80% de los IH alcanzan el tamaño final a los 3 meses de edad, lo que pone de relieve la necesidad de un seguimiento temprano.
- Las indicaciones para el tratamiento incluyen enfermedades intestinales que amenazan la vida, riesgos funcionales (visuales, de alimentación), ulceración y distorsión cosmética.
- El propranolol oral es el tratamiento de primera línea, que demuestra un rápido encogimiento y requiere un mínimo de 6 meses de tratamiento.
Conclusiones:
- La detección temprana y el seguimiento son cruciales para identificar los hemangiomas infantiles en riesgo.
- El propranolol oral es un tratamiento de primera línea seguro y eficaz para la EI que requiere intervención.
- El inicio oportuno del tratamiento con propranolol puede prevenir las complicaciones graves asociadas con los hemangiomas infantiles.
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