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Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)

We present a series of four newborns diagnosed with complicated congenital vascular anomalies, with different localization: Congenital lymphatic malformation (CLM) on the left hemithorax extending on the left upper limb; congenital hepatic hemangioma (CHH) with important complications in the first 7...

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Autores principales: Cîrstoveanu, Cătălin, Bizubac, Ana Mihaela, Mustea, Cristina, Manolache, Ștefan, Istrate-Bârzan, Alexandra, Sfrijan, Doinița, Marcu, Veronica, Iozsa, Dan-Alexandru, Spătaru, Radu-Iulian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: D.A. Spandidos 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383751/
https://www.ncbi.nlm.nih.gov/pubmed/34504551
http://dx.doi.org/10.3892/etm.2021.10531
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author Cîrstoveanu, Cătălin
Bizubac, Ana Mihaela
Mustea, Cristina
Manolache, Ștefan
Istrate-Bârzan, Alexandra
Sfrijan, Doinița
Marcu, Veronica
Iozsa, Dan-Alexandru
Spătaru, Radu-Iulian
author_facet Cîrstoveanu, Cătălin
Bizubac, Ana Mihaela
Mustea, Cristina
Manolache, Ștefan
Istrate-Bârzan, Alexandra
Sfrijan, Doinița
Marcu, Veronica
Iozsa, Dan-Alexandru
Spătaru, Radu-Iulian
author_sort Cîrstoveanu, Cătălin
collection PubMed
description We present a series of four newborns diagnosed with complicated congenital vascular anomalies, with different localization: Congenital lymphatic malformation (CLM) on the left hemithorax extending on the left upper limb; congenital hepatic hemangioma (CHH) with important complications in the first 7 weeks of life; Kaposiform hemangioendothelioma (KHE) of the left lower limb complicated with Kasabach Merritt phenomenon (KMM) and most probable diffuse capillary malformation with overgrowth (DCMO). All patients were treated with combined antiproliferative therapy with sirolimus and propranolol. The initial dose of sirolimus was 0.45-0.5 mg/m(2) with doses adjusted according to plasmatic levels. Therapeutic intervals of sirolimus were considered at plasmatic levels of 7-12 ng/ml. Our aim was to use the lowest therapeutic dose in order to avoid possible side effects. Propranolol was initiated in doses of 0.5-1.0 mg/kg/day and was increased up to 3.0 mg/kg/day depending on tolerability. Following two months, every patient showed a marked reduction in the size of the mass, improvement in overall appearance or even calcification in the liver vascular tumor. No patient showed life threatening side effects to the treatment. Hypertriglyceridemia was the only side effect noted in all patients. This is in accordance with several international studies, which try to demonstrate the importance of sirolimus in neonatal vascular malformations in monotherapy or combined with different drugs.
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spelling pubmed-83837512021-09-08 Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports) Cîrstoveanu, Cătălin Bizubac, Ana Mihaela Mustea, Cristina Manolache, Ștefan Istrate-Bârzan, Alexandra Sfrijan, Doinița Marcu, Veronica Iozsa, Dan-Alexandru Spătaru, Radu-Iulian Exp Ther Med Articles We present a series of four newborns diagnosed with complicated congenital vascular anomalies, with different localization: Congenital lymphatic malformation (CLM) on the left hemithorax extending on the left upper limb; congenital hepatic hemangioma (CHH) with important complications in the first 7 weeks of life; Kaposiform hemangioendothelioma (KHE) of the left lower limb complicated with Kasabach Merritt phenomenon (KMM) and most probable diffuse capillary malformation with overgrowth (DCMO). All patients were treated with combined antiproliferative therapy with sirolimus and propranolol. The initial dose of sirolimus was 0.45-0.5 mg/m(2) with doses adjusted according to plasmatic levels. Therapeutic intervals of sirolimus were considered at plasmatic levels of 7-12 ng/ml. Our aim was to use the lowest therapeutic dose in order to avoid possible side effects. Propranolol was initiated in doses of 0.5-1.0 mg/kg/day and was increased up to 3.0 mg/kg/day depending on tolerability. Following two months, every patient showed a marked reduction in the size of the mass, improvement in overall appearance or even calcification in the liver vascular tumor. No patient showed life threatening side effects to the treatment. Hypertriglyceridemia was the only side effect noted in all patients. This is in accordance with several international studies, which try to demonstrate the importance of sirolimus in neonatal vascular malformations in monotherapy or combined with different drugs. D.A. Spandidos 2021-10 2021-08-02 /pmc/articles/PMC8383751/ /pubmed/34504551 http://dx.doi.org/10.3892/etm.2021.10531 Text en Copyright: © Cîrstoveanu et al. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Articles
Cîrstoveanu, Cătălin
Bizubac, Ana Mihaela
Mustea, Cristina
Manolache, Ștefan
Istrate-Bârzan, Alexandra
Sfrijan, Doinița
Marcu, Veronica
Iozsa, Dan-Alexandru
Spătaru, Radu-Iulian
Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)
title Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)
title_full Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)
title_fullStr Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)
title_full_unstemmed Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)
title_short Antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (Case reports)
title_sort antiproliferative therapy with sirolimus and propranolol for congenital vascular anomalies in newborns (case reports)
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383751/
https://www.ncbi.nlm.nih.gov/pubmed/34504551
http://dx.doi.org/10.3892/etm.2021.10531
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