Léauté-Labrèze C, Labbé L, Grenier N, Berge J, Vergnes P, Taïeb A
Unité de Dermatologie Pédiatrique, Hôpital Pellegrin-enfants, Bordeaux.
Ann Dermatol Venereol. 1998 Mar;125(3):174-8.
High-dose corticosteroids are the primary means of controlling alarming hemangiomas. However, only 2/3 of these life-threatening hemangiomas regress or are stabilized with corticosteroids: and for others there is no regularly safe and effective treatment. Contradictory publications have been reported about the efficacy of interferon (INF) alpha in hemangiomas, we report our experience concerning the management of 7 cases.
Seven infants have been treated with INF alpha-2b in our Pediatric Dermatology Unit. All hemangiomas were corticosteroid resistant. Hemangiomas were located on head and neck in 6 cases and on lower limb in one case in association with platelet trapping syndrome. Mean age at beginning of treatment was 7.5 months and mean duration of treatment was 5 months. INF alpha-2b was given daily in subcutaneous injections of 3 millions units per square meter of body surface area.
After one month of treatment, 2 cases of facial hemangiomas showed a dramatic improvement, and INF alpha-2b was maintained for one year. One case was stabilized, but INF was ineffective in 3 cases after 2 months of treatment (the child with platelet trapping syndrome died at 4 months of age). The treatment had to be stopped in one case because of hepatitis. No long term side effects were noted with a mean follow-up of 27 months.
INF alpha can be an interesting alternative therapy for infantile hemangiomas. However, only a minority of patients can be considered as excellent responders at current dosages and long term secondary effects cannot be excluded.
大剂量皮质类固醇是控制重症血管瘤的主要手段。然而，这些危及生命的血管瘤中只有2/3会消退或通过皮质类固醇得以稳定：而对于其他血管瘤则没有常规安全有效的治疗方法。关于干扰素（INF）α在血管瘤治疗中的疗效已有相互矛盾的报道，我们报告7例患者的治疗经验。
我们小儿皮肤科病房对7例婴儿使用INFα-2b进行治疗。所有血管瘤均对皮质类固醇耐药。6例血管瘤位于头颈部，1例位于下肢并伴有血小板捕获综合征。治疗开始时的平均年龄为7.5个月，平均治疗持续时间为5个月。INFα-2b通过皮下注射，每天每平方米体表面积给予300万单位。
治疗1个月后，2例面部血管瘤有显著改善，INFα-2b持续使用1年。1例病情稳定，但3例在治疗2个月后无效（患有血小板捕获综合征的患儿在4个月时死亡）。1例因肝炎不得不停止治疗。平均随访27个月，未发现长期副作用。
INFα可作为婴儿血管瘤一种有趣的替代疗法。然而，以目前的剂量，只有少数患者可被视为疗效极佳，且不能排除长期的继发效应。
