Propranolol in the treatment of subglottic haemangioma

Abstract

Objective – Subglottic infantile haemangioma (SGH) is a rare but potentially life-threatening disease. We describe a case of successful treatment with propranolol of a severely respiratory compromised 2-month-old infant with an obstructing SGH.

Case report – A fullterm 2-month-old male infant, weighing 4.8 kg, without cutaneous haemangioma, presented with stridor, dyspnoea, oxygen desaturation and tachycardia. Contrast enhanced neck–chest CT scan was used to diagnose a 5×7×7 mm subglottic elliptic lesion, referable to SGH with a free air column of 2 mm wide. Per oral propranolol was started with a therapeutic dosage of 2 mg/kg/day in 3 administrations. On the second day of treatment there was rapid clinical improvement of the infant with withdrawal of respiratory symptoms. After treatment, the control CT showed the regression of SGH. Twenty-one months later the patient is without respiratory symptoms.

Conclusion – Propranolol medical treatment should be considered in all subglottic haemangioma, even in acute cases.