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      La cytostéatonécrose du nouveau-né: à propos de deux observations Translated title: Fat necrosis of the newborn: report of two cases

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          Abstract

          La cytostéatonécrose est une lésion de survenue rare dont la pathogénie est incomplètement connue. Elle se présente sous la forme de placards cutanés indurés et violacés sur peau claire ou hyperchromiques sur peau noire, localisés souvent au niveau de la face, du tronc, des fesses et de la racine des membres. Probablement due à une anomalie des tissus graisseux: trouble du métabolisme des graisses avec excès de graisses saturées dans le tissu sous-cutané, hypoxie par souffrance néonatale ou hypothermie favorisant la cristallisation des graisses saturées et la nécrose graisseuse. L’évolution de la cytostéatonécrose est en règle bénigne. Mais certaines complications (l'hypocalcémie et les troubles métaboliques) peuvent survenir et engendrer le pronostic vital. Nous rapportons deux cas de cytostéatonécrose néonatale néonatale précoce dans le but est de décrire cette symptomatologie et de préciser l’évolution des lésions à moyen terme.

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          Most cited references 12

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          Subcutaneous fat necrosis of the newborn: hypercalcaemia with hepatic and atrial myocardial calcification.

          Subcutaneous fat necrosis of the newborn (SCFN) is a very rare disorder, which can be complicated by hypercalcaemia and thrombocytopenia. The case is presented of an infant with SCFN and symptomatic hypercalcaemia, who developed calcifications in the liver, the inferior vena cava, and the atrial septum of the heart. The hypercalcaemia was treated with hyperhydration, frusemide, glucocorticoids, and a diet low in calcium and vitamin D. Clinical features, diagnosis, complications, and treatment of this rare condition are discussed.
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            Subcutaneous fat necrosis associated with severe hypocalcaemia in a neonate.

            Subcutaneous fat necrosis (SFN) of the newborn is an uncommon disorder of the adipose tissue, mostly affecting full-term or post-term newborns who experience perinatal distress. The lesions of SFN typically occur during the first six weeks of life; they are usually self-limited and no specific therapy is required. The disorder may be rarely complicated with hypercalcaemia. We present the case of a neonate with perinatal asphyxia who manifested SFN followed by hypocalcaemia instead of hypercalcaemia and a biochemical profile of pseudohypoparathyroidism four weeks after the eruption of skin lesions. The infant was treated with alfacalcidiol. Blood biochemistry was normalized within one week and serum parathyroid hormone levels declined to normal over the next two months. It is suggested that perinatal asphyxia was the common etiopathogenetic factor for the development of both SFN and pseudohypoparathyroidism.
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              [Subcutaneous fat necrosis in the newborn: a risk for severe hypercalcemia].

              Hypercalcemia associated with subcutaneous fat necrosis (SCN) is a well known but rare event in the newborn. A newborn infant with a history of SCN was admitted because of anorexia, adynamia, polyuria and polydipsia at 6 weeks of age. Serum calcium was markedly increased on admission, while it was normal on the first day of life. Evolution was favourable after treatment including isotonic saline solution, furosemide, corticosteroids, calcitonin and a low calcium and vitamin D diet. Hypercalcemia was severe enough to potentially induces fatal complications in this case. Neonates who develop skin lesions consistent with SCN should be followed-up for possible onset of hypercalcemia and treated in due time. The treatment of hypercalcemia in SCN is reviewed.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                16 September 2015
                2015
                : 22
                Affiliations
                [1 ]Service de Néonatologie, CHU Mohamed VI, Faculté de Médecine et de Pharmacie d'Oujda, Université Mohammed 1 er, Oujda, Maroc
                [2 ]Cabinet de Pédiatrie privé, Boulevard Allal Ben Abdellah, Angle Idriss Al Akbar, Oujda, Maroc
                Author notes
                [& ]Corresponding author: Sahar Messaoudi, Service de Néonatologie, CHU Mohamed VI, Faculté de Médecine et de Pharmacie d'Oujda, Université Mohammed 1 er, Oujda, Maroc
                Article
                PAMJ-22-34
                10.11604/pamj.2015.22.34.6957
                4662506
                © Sahar Messaoudi et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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