Multinodular hemangiomatosis of the liver generally occurs in the first six months of life, with the triad of hepatomegaly, high-output congestive heart failure, and cutaneous hemangiomas.1 Early reviews described a poor prognosis with death, generally due to intractable congestive heart failure, occurring within the first year.1,2 More recent reports suggest that a favorable outcome usually results from vigorous supportive care and high-dose corticosteroid therapy.2-4 We have recently encountered two patients, however, who received long-term high-dose corticosteroid therapy without apparent response. In one instance, spontaneous involution and hemodynamic improvement was noted; in the other, hepatic artery ligation was performed successfully. Both patients are alive and well more than two years after diagnosis.
Report of Cases.—Case 1.—This infant was well until 3 months of age when poor feeding, respiratory distress, and two episodes of dusky skin color with feedings were noted. Physical examination disclosed an acutely ill
SHANNON K, BUCHANAN GR, VOTTELER TP. Multiple Hepatic Hemangiomas: Failure of Corticosteroid Therapy and Successful Hepatic Artery Ligation. Am J Dis Child. 1982;136(3):275–276. doi:10.1001/archpedi.1982.03970390089025
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