35
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Neonatal subcutaneous fat necrosis with hypercalcemia treatment using calcitonin

      case-report
      , MD
      Saudi Medical Journal
      Saudi Medical Journal

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Subcutaneous fat necrosis of newborn is a form of noninfectious panniculitis. It is an uncommon condition and mostly occurs in full-term infants within first weeks of life that have had a significant condition such as hypoxic-ischemic encephalopathy at the time of birth. Subcutaneous fat necrosis of newborn is usually a self-limiting condition but may be associated with hypercalcemia, which may lead to life threatening levels. Hypercalcemia is a significant reason of subcutaneous fat necrosis and needs an intervention involving hyperhydration, calcitonin, diuretics, steroids and sometimes bisphosphonate in resistant cases. Here, we have reported the case of a term infant who developed extensive subcutaneous fat necrosis in the first week of life after significant perinatal hypoxic injury. Her condition was complicated by hypercalcemia resistant to prolonged medical treatment with hyperhydration, diuretic and steroid but eventually the infant responded to high doses of calcitonin.

          Related collections

          Most cited references7

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Subcutaneous fat necrosis of the newborn

          Key Clinical Message Subcutaneous fat necrosis (SCFN) is a rare fat tissue inflammation of the newborn. Risk factors include cord prolapse, perinatal asphyxia, therapeutic hypothermia, meconium aspiration, and sepsis. When present, hypercalcemia comes with lethargy, hypotonia, irritability, vomiting, polyuria, polydipsia, constipation, and dehydration. Kidney injury must be avoided. SCFN is often completely autoresolutive.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found

            Pamidronate: Treatment for Severe Hypercalcemia in Neonatal Subcutaneous Fat Necrosis

            Background: Subcutaneous fat necrosis (SCFN) of the newborn is an uncommon disorder that occurs in the first weeks of life after foetal distress. It can be complicated by potentially life-threatening hypercalcemia. Treatments of hypercalcemia have included hydration, furosemide and corticosteroids. Only one report has described the use of intravenous bisphosphonates for this condition. We propose that pamidronate could be the first line therapy for severe hypercalcemia in SCFN. Patients and Results: Four newborns presented between 2001 and 2004 with SCFN complicated by severe hypercalcemia. At diagnosis, ionized calcium levels were higher than 1.4 mmol/l and were associated with high urinary calcium/creatinine ratios and high 1,25-dihydroxyvitamin D levels. Despite treatment with IV fluids, low calcium diet and furosemide, calcium levels remained high. The patients were given 3–4 doses (0.25–0.50 mg/kg/dose) of pamidronate. Urinary calcium/creatinine ratios and calcium levels decreased within 48–96 h. 1,25-dihydroxyvitamin D levels normalized with resolution of the skin lesions. No persistent nephrocalcinosis was observed. Conclusion: Pamidronate is effective, well-tolerated in the short-term and obviates the need for prolonged treatment with furosemide and corticosteroids. To prevent nephrocalcinosis, pamidronate might be considered as first line treatment for severe hypercalcemia in SCFN.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Subcutaneous fat necrosis of the newborn: clinical manifestations in two cases*

              Subcutaneous fat necrosis of the newborn is an unusual form of panniculitis, with few cases described in medical literature. The disease affects newborns at term or post-term, with normal general health. We describe two cases of newborns affected by the disease. One of them already had lesions since birth. Also, we discuss the use of puncture for diagnostic assistance.
                Bookmark

                Author and article information

                Journal
                Saudi Med J
                Saudi Med J
                Saudi Medical Journal
                Saudi Medical Journal (Saudi Arabia )
                0379-5284
                June 2018
                : 39
                : 6
                : 622-626
                Affiliations
                [1] From the Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
                Author notes
                Address correspondence and reprint request to: Dr. Khouloud A. Alsofyani, Department of Pediatric, Section of Pediatric Critical Care , King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. E-mail: alsofyani.drk@ 123456yahoo.com
                Article
                SaudiMedJ-39-622
                10.15537/smj.2018.6.22025
                6146218
                29915859
                faeff733-617e-4c6c-8571-e584048a12b2
                Copyright: © Saudi Medical Journal

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 January 2018
                : 23 May 2018
                Categories
                Case Report

                Comments

                Comment on this article