Adrenal suppression following intralesional corticosteroids for periocular haemangiomas

Arch Dis Child. 2011 Jun;96(6):587-9. doi: 10.1136/adc.2010.204859. Epub 2011 Feb 14.

Abstract

Background/aims: Treatment with intralesional triamcinolone/betamethasone is recommended for infantile sight-threatening periocular haemangiomas. This study investigates the endocrine and weight changes in 15 infants undergoing therapy over 12 years.

Methods: 15 infants, median age 19 weeks (range 10-56) receiving intra/perilesional triamcinolone/betamethasone underwent serial measurement of weight, early morning serum cortisol and adrenocorticotropic hormone (ACTH) before and after injection.

Results: Cortisol fell from a median (range) of 383 (112-594) to 28 (<10-506) nmol/l (p=0.005) and ACTH from 26 (14-134) to 9 (5-20) ng/l (p=0.05) from before injection to 4 weeks after treatment. Prolonged adrenal suppression occurred in 13 out of 15 cases with time to recovery being 19.5 (4-65) weeks. Failure to gain weight appropriately was observed in 14 infants but recovered once normal adrenal function was re-established.

Conclusion: Prolonged adrenal suppression following triamcinolone/betamethasone injection for periocular haemangiomas is common and associated with faltering weight gain.

MeSH terms

  • Adrenal Insufficiency / blood
  • Adrenal Insufficiency / chemically induced*
  • Adrenocorticotropic Hormone / blood
  • Betamethasone / administration & dosage
  • Betamethasone / adverse effects
  • Child, Preschool
  • Drug Combinations
  • Eyelid Neoplasms / drug therapy*
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects*
  • Hemangioma / drug therapy*
  • Humans
  • Hydrocortisone / blood
  • Infant
  • Injections, Intralesional
  • Male
  • Retrospective Studies
  • Triamcinolone / administration & dosage
  • Triamcinolone / adverse effects
  • Weight Gain / drug effects

Substances

  • Drug Combinations
  • Glucocorticoids
  • Triamcinolone
  • Adrenocorticotropic Hormone
  • Betamethasone
  • Hydrocortisone