Medical College of Wisconsin
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Immunosuppressive effects in infants treated with corticosteroids for infantile hemangiomas. Arch Dermatol 2010 Jul;146(7):767-74

Date

05/19/2010

Pubmed ID

20479291

DOI

10.1001/archdermatol.2010.90

Abstract

BACKGROUND: Infantile hemangiomas are the most common benign tumors of infancy. Up to 38% of hemangiomas require treatment with systemic medications because of complications. Corticosteroids have been the mainstay for treating such hemangiomas. However, prospective studies evaluating their immunosuppressive effects in infants with hemangiomas are lacking.

OBSERVATIONS: Sixteen patients who presented to the Birthmark and Vascular Anomalies Center at the Children's Hospital of Wisconsin from November 1, 2006, through February 28, 2008, were enrolled in the study. A significant reduction in the numbers of all B- and T-lymphocyte subpopulations was observed after corticosteroid administration. CD19(+) B lymphocytes and CD4(+) T cells were significantly reduced by 8 weeks of corticosteroid therapy, whereas CD8(+) T cells were reduced at week 16 compared with baseline. Immune function was also affected because 13 and 5 patients had protective diphtheria titers and tetanus titers, respectively, 3 months after discontinuation of corticosteroid therapy compared with baseline.

CONCLUSIONS: These results demonstrate that corticosteroids measurably affect both lymphocyte cell numbers and function in this patient population. Prophylaxis with the combination of trimethoprim and sulfamethoxazole should be considered in infants treated with corticosteroids for infantile hemangiomas. We also recommend that tetanus and diphtheria antibodies be checked in patients who receive oral corticosteroids during the immunization period and that additional immunization be administered if the titers are not protective after corticosteroid therapy.

Author List

Kelly ME, Juern AM, Grossman WJ, Schauer DW, Drolet BA



MESH terms used to index this publication - Major topics in bold

CD4-CD8 Ratio
Dose-Response Relationship, Drug
Female
Flow Cytometry
Follow-Up Studies
Glucocorticoids
Hemangioma
Humans
Immunity, Cellular
Immunosuppression
Infant
Male
Prednisolone
Prognosis
Prospective Studies
T-Lymphocytes
jenkins-FCD Prod-387 b0ced2662056320369de4e5cd5f21c218c03feb3