Propranolol-induced hyperkalemia in infantile hemangioma patients: How serious is it?

Background: Infantile hemangioma is the most frequent benign vascular tumor of infancy, which has a specific clinical history of early growth, followed by spontaneous remission. Since the fortuitous discovery of propranolol's efficacy in 2008, the management of infantile hemangioma has been quickly developing. Methods: This study is a retrospective cohort study. Electronic search in the patient's registry of King Khalid University Hospital, Riyadh, Saudi Arabia, was performed using the keywords hemangioma, haemangioma, infantile hemangioma, and vascular tumors. The search revealed a total of 101 subjects for which 56 were included and 45 were excluded. Results: A total of 56 patients with infantile hemangioma were evaluated in this study. The majority were females. The F: M ratio is 3.4:1. The highest percentage of the patients was delivered by the elective cesarian section, that is, 23 (41.1%), followed by spontaneous vaginal delivery, that is, 19 (33.9%). Full-term patients were 27 (48%), whereas the pre-term patients were 21 (37%). The total number of patients who developed hyperkalemia while on propranolol was 12 (31%). There was no statistically significant difference (P > 0.05) between patients who developed hyperkalemia and patients who did not develop hyperkalemia in terms of gender, gestational age, mode of delivery, size and location of hemangioma, or concomitant topical timolol use. Conclusion: Hyperkalemia is benign and transient, although solid conclusive opinions cannot be drawn because of the small sample size and the retrospective nature of the study.