HEMANGIOMAS INFANTILES: HALLAZGOS CLINICOS Y TRATAMIENTO CON ESPECIAL REFERENCIA A LA TERAPIA CON METILPREDNISOLONA A DOSIS ALTAS

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En esta reseña, la autora analiza las características biológicas y clínicas de los hemangiomas infantiles, así como el diagnóstico, las complicaciones y las opciones terapéuticas.
uysal.jpg Autor:
Kamer Mutafoglu Uysal
Columnista Experto de SIIC
Artículos publicados por Kamer Mutafoglu Uysal
Recepción del artículo
29 de Septiembre, 2003
Primera edición
12 de Marzo, 2004
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Los hemangiomas son los tumores más frecuentes en la infancia. Sin embargo, hay muchos interrogantes acerca de la patogénesis y políticas de tratamiento razonables que aún permanecen sin respuesta. Si bien la mayoría de los hemangiomas involucionan espontáneamente y no requieren terapia, aproximadamente el 10% se complica y necesita una actitud intervencionista. Los corticoides sistémicos constituyen la base del tratamiento, desde hace aproximadamente 40 años, cuando la terapia sistémica está indicada. No obstante, las recomendaciones acerca del régimen óptimo corticosteroide varían ampliamente. El propósito de este artículo es analizar las características biológicas y clínicas de los hemangiomas infantiles, así como presentar algunas opciones terapéuticas, especialmente la terapia corticosteroide sistémica con dosis altas, para estas lesiones.

Palabras clave
Hemangioma infantil, terapia corticosteroide


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Abstract
Hemangiomas are the most common tumor of infancy, yet many questions about the pathogenesis and rational treatment policies still remain unanswered. Although a vast majority of hemangiomas involute spontaneously and require no therapy, approximately 10% of hemangiomas become problematic and need intervention. When systemic therapy is indicated, systemic corticosteroids have remained the mainstay of therapy for nearly 40 years. However, recommendations on optimal corticosteroid regimen vary widely. The purpose of this article is to review the biological and clinical characteristics of infantile hemangiomas as well as to present some of the therapeutic options, with a focus on high-dose systemic corticosteroid therapy for the management of these lesions.

Key words
Hemangioma infantil, terapia corticosteroide


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Especialidades
Principal: Pediatría
Relacionadas: Anatomía Patológica, Cirugía, Farmacología, Hematología, Oncología



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Bibliografía del artículo
  1. Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconst Surg 1982; 69: 412-20.
  2. Mulliken JB, Young AE. Vascular Birthmarks: Hemangiomas and Malformations. Philadelphia, WB Saunders. 1988: pp: 24-103.
  3. Jacobs AH. Strawberry hemangioma : The natural history of the untreated lesion. Calif Med 1957; 86: 8-10.
  4. Pratt AG. Birthmarks in infants. Arch Dermatol 1953; 67: 302-11.
  5. Hidano A, Nakajima S. Earliest features of the strawberry mark in the newborn. Br J Dermatol 1972; 87: 138-144.
  6. Amir J, Mentzker A, Krikler R, Reisner SH. Strawberry hemangioma in preterm infants. Pediatr Dermatol 1986; 3: 331-32.
  7. Bowers RE, Graham EA, Tomlinson KM. The natural history of strawberry nevus. Arch Dermatol 1960; 82 : 667-70.
  8. Enjolras O, Gelbert F. Superficial hemangiomas : association and management. Pediatr Dermatol 1997; 14: 173-79.
  9. Burton BK, Schulz CJ, Angle B, Burd LI. An increased incidence of hemangiomas in infants born following chorionic villus sampling (CVS). Prenat Diag 1995; 15:209-14.
  10. Cheung DS, Warman WL, Mull,iken JB. Hemangioma in twins. Ann Plast Surg 1997; 38: 269-74.
  11. Walter JB, Blei FM, Marchuk DA. Description of a novel hereditary form of capillary hemangioma and genetic mapping of predisposing chromosomal loci (abstr) Am J Hum Genet 1997; 61 (suppl) A: 299.
  12. Walter JB, Blei FM, anderson JL, et al. Genetic mapping of a novel hereditary form of infantile hemangioma. Am J Med Genet 1999; 82: 77-83.
  13. Boon LM, Enjolras O, Mulliken JB. Congenital hemangioma : Evidence of accelerated involution. J Pediatr 1996; 128: 329-35.
  14. Low DW. Hemangiomas and vascular malfomations. Semin Pediatr Surg. 1994; 3(2):40-61.
  15. Fishman SJ, Mulliken BJ. Hemangiomas and vascular malformations of infancy and childhood. Pediatr Clin North Am 1993; 40 (6): 1177-1200.
  16. Drolet BA, Esterly NB, Frieden IJ. Hemangiomas in children. N Engl J Med 1999; 341: 173-81.
  17. Gampper TJ, Morgan FR. Vascular anomalies: Hemangiomas. Plast Reconst Surg 2002; 110: 572-85.
  18. Berg JN, Walter JW, Thisanagayam U, et al. Evidence for losss of heterozygosity of 5q in sporadic hem : are somatic mutations involved in hemangioma formation J Clin Pathol 2001: 54:249-52.
  19. Walter JW, North PE, Waner M, et al. Somatic mutation of vascular endothelial growth factor receptors in juvenile hemangioma. Genes Chromosomes Cancer. 2002 ;33(3):295-303.
  20. Bischoff J. Monoclonal expansion of endothelial cells in hemangioma : An intrensec defect with extrinsic consequences Trends Cardiovasc Med 2002; 12:220-24.
  21. Folkman J. Clinical applications of research on angiogenesis. N Engl J Med1995; 333 (26): 1757-63.
  22. Takahashi K, Mulliken JB, Kozakewitz HPW, et al. Cellular markers that distinguish the phases of hemangioma during infancy and childhood. J Clin Invest 1994; 93: 2357-64.
  23. Dethlefsen SM, mulliken JB, Glowacki J. An ultrastructural study of mast cells interaction in hemangiomas. Ultrastruct Pathol 1986; 10: 175-83.
  24. Chang E, Most D, Bresnick S, et al. Proliferative hemangiomas: Analysis of cytokine gene expression and angiogenesis. Plast Reconst Surg 199; 103: 1-9.
  25. Chang E, Boyd A, Nelcon CC, et al. Successful treatment of infantile hem with interferon alpha-2b. J Pediatr Hematol Oncol 1997; 19: 237-44.
  26. Razon MJ, Kraling BM, Mulliken JB, Bischoff J. Increased apoptosis coincidens with onset of involution of infantile hemangioma. Microcirculation 1998; 5: 189-95.
  27. Orlow SJ, Isahoff MS, Blei F. Increased risk of symptomatic hemangiomas of the airway in association with cutaneous hemangiomas in a "beard" distribution. J Pediatr 1997; 131: 643-6.
  28. Dubois J, Garel L. Imaging and therapeutic approach of hemangiomas and vascular malformations in the pediatric age group. Pediatr Radiol 1999; 29: 879-893.
  29. Goldberg DJ, Sciales CW. Pyogenic granuloma in children: treatment with the flashlamp-pumped pulsed dye laser. J Dermatol Surg Oncol 1991; 17: 960-2.
  30. Vin-Christian K, McCalmont TH, Frieden IJ. Kaposiform hemangioendothelioma: an aggressive, locally invasive vascular tumor that can mimic hemangioma of infancy. Arch Dermatol 1997; 133: 1573-78.
  31. Zukerberg LR, Nickoloff BJ, Weiss SW. Kaposiform hemangioendothelioma of infancy and childhood: An aggressive neoplasm associated with Kasabach Merritt Syndrome and lymphangiomatosis. Am J Surg Pathol 1993; 17: 321-8.
  32. Jones EW, Orkin M. Tufted angioma (angioblastoma): A benign progressive angioma, not to be confused with Kaposi\'s sarcoma or low-grade angiosarcoma. J Am Acad Dermatol 1989; 20: 214-25.
  33. Kaufmann SL, Stout AP. Hemangiopericytoma in children. Cancer 1960; 13: 695-98.
  34. Hoey AA, Letts RM, Jimenez C. Infantile hemangiopericytoma of the musculoskeletal system: case report and literature review. J Pediatr Ortop 1998; 18: 359-62.
  35. Boon LM, Burrows PE, Paltiel HJ, et al. Hepatic vascular anomalies of infancy: a twenty seven year experience. J Pediatr 1996; 129: 346-54.
  36. Golitz LE, Rudikoff J, O\'Meara OP. Diffuse neonatal hemangiomatosis. Pediatr Dermatol 1986; 3: 145-52.
  37. Geller JD, Topper SF, Hashimoto K. Diffuse neonatal hemangiomatosis: A new constellation of findings. J Am Acad Dermatol 1991; 24: 816-8.
  38. Kasabach HHM, Merritt KK. Capillary hemangioma with extensive purpura. Report of a case. Am J Dis Child 1940; 59: 1063-70.
  39. Hall GW. Kasabach-Merritt Syndrome: Pathogenesis and management. Br J Haematol. 2001;112(4):851-62.
  40. Enjolras O, Wassef M, Mazoyer E, et al. Infants with Kasabach-Merritt Syndrome do not have "true" hemangiomas. J Pediatr 1997; 130: 631-40.
  41. Sarkar M, Mulliken JB, Kozakewich HP, Robertso RL, Burrows PE. Thrombocytopenic coagulopaty (Kasabach-Merritt phenomenon) is associated with Kaposiform hemangioendothelioma and not with common infantile hemangioma. Plast Reconst Surg 1997; 100: 1377-86.
  42. Frieden IJ, Eichenfield LF, Esterly NB, Geronemus R, Mallory SB. Guidelines of care for hemangiomas of infancy. American Academy of Dermatology Guidelines / Outcomes Committee. J Am Acad Dermatol 1997; 37: 631-37.
  43. Frieden IJ. Which hemangiomas to treat and how. Arch Dermatol 1997; 133: 1593-95.
  44. Tanner JL, Dechert MP, Frieden IJ. Growing with a facial hemangioma : parents and child coping and adoptation. Pediatrics 1998; 101: 446-52.
  45. Enjolras O, Riche MC, Merland JJ, Escande JP. Management of alarming hemangiomas in infancy: a review of 25 cases. Pediatrics 1990; 85:491-98.
  46. Sadan N, Wolach B. Treatment of hemangiomas of infants with high doses of prednisone. J Pediatr 1996; 128: 141-46.
  47. Gangopadhyay AN, Sinka CK, Gopal SC, Gupta DK, Sahoo SP, Ahmad M. Role of steroid in childhood hemangioma : A ten year review. Int Surg 1997; 82: 49-51.
  48. Zarem HA, Edgerton MT. Induced resolution of cavernous hemangiomas following prednisolone therapy. Plast Reconst Surg 1967; 39: 76-83.
  49. Katz HP, Askin J. Multiple hemangioma with thrombocytopenia. An unusual case with comments on steroid therapy. Am J Dis Child 1968; 115: 351-7.
  50. Fost NC, Esterly NB. Successful treatment of juvenile hemangiomas with prednisone. J Pediatr 1968; 72: 351-7.
  51. hiles DA, Pilchard WA. Corticosteroid control of neonatal hemangiomas of the orbita and ocular adnexa. Am J Ophtalmol 1971; 71: 1003-8.
  52. Cohen Sr, wang CI. Steroid treatment of hemangioma of the head and neck in children. Ann Otol 1972; 81: 584-90.
  53. Edgerton MT. the treatment of hemangiomas : with special reference to the role of steroid therapy. Ann Surg 1976; 183: 517-32.
  54. Brown SH, Neerhout RC, Fonkalsrud EW. Prednisone therapy in the management of large hemangiomas in infants and children. Surgery 1972; 71: 168-73.
  55. Akyuz C, Nilgun Y, Tezer K, Munevver B. Management of cutaneous hemangiomas: a retrospective analysis of 1109 cases and comparision of conventional dose prednisolone with high-dose methylprednisolone therapy. Pediatr Hematol Oncol 2001; 18: 47-55.
  56. Boon LM, MacDonald DM, Mulliken JB. Complications of systemic corticosteroid therapy for problematic hemangioma. Plast Reconst Surg 1999; 104: 1616-23.
  57. Bennett ML, Fleischer AB, Chamlin SL, Frieden IJ. Oral corticosteroid use is effective for cutaneous hemangiomas. An evidence-based evaluation. Arch Dermatol 2001; 137: 1208-13.
  58. Uysal KM, Olgun N, Erbay A, Sarialioglu F. High-dose oral methylprednisolone therapy in childhood hemangiomas. Pediatr Hematol Oncol. 2001;18 (5):335-41.
  59. Özsoylu S, Irken G, Gürgey A. High dose intravenous methylprednisolone for Kasabach-Merritt syndrome. Eur J Pediatr 1989; 148: 403-405.
  60. Özsoylu S. Megadose methylprednisolone for Kasabach-Merritt syndrome. Am J Pediatr Hematol Oncol 1993; 10: 197-198.
  61. Özsoylu S. Highj-dose intravenous methylprednisolone (HDIVMP) in hematologic disorders. Hematol Rev 1990; 4: 197-207.
  62. Özsoylu S, Sayli TR, Öztürk G. Oral megadose methylprednisolone versus intravenous immunoglobulin for acute childhood idiopathic thrombocytopenic purpura. Pediatr Hematol Oncol. 1993;10:317-21.
  63. Hicsonmez G, Gumruk F, Zamani PV, et al. High-dose methylprednisolone for children with acute lymphoblastic leukemia and unfavorable presenting features. Eur J Haematol. 1997; 58:26-31.
  64. Sherrington CA, Sim DKY, Freezer NJ, Robertson CF. Subglottic haemangioma. Arch Dis Child 1997; 76: 458-59.
  65. Kushner BJ. Intralesional corticosteroid injection for infantile adnexal hemangioma. Am J Ophtalmol 1982; 93: 496-506.
  66. Kushner BJ. The treatment of periorbsital infantile hemangiomas with intralesional corticosteroid. Plast Reconst Surg 1985; 76: 517-26.
  67. Sloan GM, Reinisch JF, Nichter LS, Saber WL, Lew K, Morwood DT. Intralesional corticosteroid therapy for infantile hemangiomas. Plast Reconst Surg 1989; 83: 59-67.
  68. Iwanaka T, Tsuchida Y, Hashizume K, Kawasaki H, Utsuki T, Komuro H. Intralesional corticosteroid injection with short-term oral prednisolone for infantile hemangiomas of the eyelid and orbit. J Ped Surg 1994; 29: 482-86.
  69. Ellis PP. Occlusion of the central retinal artery after retrobulbar corticosteroid injection. Am J Opthalmol 1978; 85: 352-56.
  70. Sutula FC, Glover AT. Eyelid necrosis following intralesional corticosteroid injection for capillary hemangioma. Ophthalmic Surg 1987; 18: 103-5.
  71. Evans DE, Zahorchak JA, Kennerdel JS. Visual loss as a result of primary optic nerve neuropathy after intralesional corticosteroid injection. Am J Opthalmol 1980; 90: 641-44.
  72. Egbert JE, Paul S, Engel WK, Summers CG. High injection pressure during intralesional injection of corticosteroids into capillary hemangiomas. Arch Ophthmol 2001; 119: 677-83.
  73. Wiatrak BJ, Reilly JS, Seid AB, et al. Open surgical excision of subglottic hemangioma in children. Int J Pediatr Otorhinolaryngol 1996; 54: 191-206.
  74. Seid AB, Pransky SM, Kearns DB. The open surgical approach to subglottic hemangioma. Int J Pediatr Otorhinolaryngol 1991; 22: 85-90.
  75. Hoeve LJ, Kuppers GLE, Verwoerd CDA. Management of infantile subglottic hemangioma: laser vaporization, submucous resection, intubation, or intralesional steroids. Int J Pediatr Otorhinolaryngol 1997; 42: 179-86.
  76. Leatherbarrow B, Noble JL, Lloyd IC. Cavernous hemangioma of the orbit. Eye 1989; 3: 90-99.
  77. Garden JM, Bakus AD. Clinical efficacy of the pulsed dye laser in the treatment of vascular lesions. J Dermatol Surg Oncol; 1993; 19: 321-6.
  78. Waner M, Suen JY, Dinehart S, Mallory SB. Laser photocoagulation of superficial proliferating hemangiomas. J Dermatol Surg Oncol; 1994; 20: 43-46.
  79. Garden JM, Bakus AD, Paller AS. Treatment of cutaneous hemangiomas by the flashlamp-pumped pulsed dye laser: prospective analysis. J Pediatr 1992; 120: 555-60.
  80. Poetke M, Philipp C, Berlien HP. Flashlamp-pumped pulsed dye laser for hemangiomas in infancy. Arch Dermatol 2000; 136: 628-32.
  81. Hohenleutner U, Landthaler M. Laser treatment of childhood hemangioma : progress or not. Lancet 2002; 360: 502-3.
  82. Batta K, Goodyear HM, Moss C, Williams HC, Hiller L, waters R. Randomised controlled study of early pulsed dye laser treatment of uncomplicated childhood hemangiomas: results of a 1-year analysis. Lancet 2002; 360: 521-27.
  83. Healy GB, McGill T, Friedman EM. Carbondioxide laser in subglottic hemangioma. An update. Ann Otol Rhinol Laryngoscope 1980; 90: 809-13.
  84. Sie KC, McGill T, Healy GB. Subglottic hemangioma: 10 year\'s experience with carbon dioxide laser. Ann Otol Rhinol Laryngol 1994; 103: 167-72.
  85. Chatrath P, Black M, Jani P, Albert DM, Bailey CM. A review of the current management of infantile subglottic hemangioma, including a comparison of CO2 laser therapy versus trachoostomy. Int J Pediatr Otorhinolaryngol 2002; 64: 143-57.
  86. Burrows PE, Lasjaunias PL, Ter Brugge KG, et al. Urgent and emergent embolization of lesions of the head and neck in children : indications and results. Pediatrics 1987; 80: 386-94.
  87. Haisley-Royster C, Enjolras O, Frieden IJ, et al. Kasabach- Merritt Phenomenon: A retrospective study of treatment with vincristine. J Pediatr Hematol Oncol 2002; 24: 459-62.
  88. Hurvitz CH, Alkalay AL, Sloninsky L, et al. Cyclophosphamide therapy in life-threatening vascular tumors. J Pediatr 1986; 109: 360-3.
  89. Castro R, Meek R, Bean C, et al. Successful treatment of a giant cavernous hemangioma with oral cyclophosphamide in an infant. Del Med J 1992; 64: 745-9.
  90. Hurvitz SA, Hurvitz CH, Sloninsky L, Sanford M. Successful treatment with cyclophosphamide of life-threatening diffuse hemangiomatosis involving the liver.J Pediatr Hematol Oncol 2000; 22: 527-32.
  91. White CW, Sondheimer HM, Crouch EC, Wilson H, Fan LL. Treatment of pulmonary hemangiomatosis with interferon alpha-2b. N Engl J med 1989; 320: 1197-1200.
  92. White CW, Wolf SJ, Korones DN, Sondheimer HM, Tosi MF, Yu A. Treatment of childhood angiomatous disease with recombinant interferon alpha-2b. J Pediatr 1991; 118: 59-66.
  93. Ezekowitz RA, Mulliken JB, Folkman J. Interferon alpha-2b therapy for life-threatening hemangiomas of infany. N Engl J Med 1992; 326: 1456-63.
  94. Bauman NM, Burke Dk, Smith RJ. Treatment of massive or life-threatening hemangiomas with recombinant interferon alpha(2a). Otolaryngol Head Neck Surg. 1997;117: 99-110.
  95. White WC. Treatment of hemangiomatosis with recombinant interferon alpha. Semin Hematol 1990; 27: 15-22.
  96. Hastings MM, Milot J, Barsoum-Homsy M, et al. Recombinant interferon alpha-2b in the treatment of vision-threatening capillary hemangiomas in childhood. J AAPOS 1997; 1: 226-30.
  97. Tamayo L, Ortiz DM, Orozco-Covarrubias L, et al. Therapeutic efficacy of interferon alpha-2b in infants with life-threatening giant hemangiomas. Arch Dermatol 1997; 133: 1567-71.
  98. Tryfonas GI, Tsikopoulos G, Liasidou E, et al. Conservative treatment of hemangiomas in infancy and childhood with interferon alpha-2a. Pediatr Surg Int 1998; 13: 590-93.
  99. Barlow CF, Priebe CJ, Mulliken JB, et al. Spastic diplegia as a complication of interferon alpha-2a treatment of hemangiomas of infancy. J Pediatr 1998; 132: 527-30.
  100. Folkman J. Successful treatment of an angiogenic disease. N Engl J Med 1989; 320: 1211-12.
  101. Crum R, Szabo S, Folkman J. A new class of steroids inhibits angiogenesis in the presence of heparin or heparin fragment. Science 1985; 230: 1375-78.

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