Educational paper: Pathogenesis of infantile haemangioma, an update 2014 (part I)

Sherief Janmohamed, Gerard Madern, pc de laat, A.p. Oranje

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25 Citations (Scopus)


Infantile haemangioma (IH) is the most frequent childhood tumour. Although it is benign and self-limiting, severe complications can arise due to localisation and fast tumour growth. Management and therapy of IH has changed greatly after 2008 with propranolol. However, the pathogenesis remains elusive. This update provides an overview of all possible mechanisms currently considered. We discuss the possibility that several mechanisms act together, although local hypoxia seems to be important. Clinically, in about half of the cases, an IH is preceded by an anaemic macula (local ischaemia) or a so-called precursor lesion. Laboratory findings indicate stabilisation and an increased transcription activity of hypoxia-inducible factor 1 alpha (HIF1 alpha), leading to up-regulation of its downstream target genes (such as vascular endothelial growth factor (VEGF)), which normally occurs in cases of hypoxia.

Conclusion: Three main hypotheses have been proposed, namely (1) the theory of tissue hypoxia, (2) the theory of embolization of placental endothelial cells and (3) the theory of increased angiogenic and vasculogenic activity.
Original languageEnglish
Pages (from-to)97-103
Number of pages6
JournalEur J Pediatr
Issue number1
Publication statusPublished - Jan 2015


  • infantile haemangioma
  • pathogensis
  • hif
  • hypoxia
  • mtor
  • vegf
  • angiogenesis
  • vasculogenesis
  • glut 1


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