scholarly journals Subcutaneous Fat Necrosis and Hypercalcemia with Nephrocalcinosis in Infancy: Case Report and Review of the Literature

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 374
Author(s):  
Katerina Chrysaidou ◽  
Georgios Sargiotis ◽  
Vasiliki Karava ◽  
Dimitrios Liasis ◽  
Victor Gourvas ◽  
...  
Keyword(s):  
Therapeutic Hypothermia ◽  
Late Onset ◽  
Subcutaneous Fat ◽  
Birth Asphyxia ◽  
Fat Necrosis ◽  
Subcutaneous Fat Necrosis ◽  
Severe Hypercalcemia ◽  
Life Threatening ◽  
Term Newborns

Subcutaneous fat necrosis is an uncommon benign panniculitis affecting more commonly full-term newborns. It has been associated with birth asphyxia and meconium aspiration, as well as therapeutic hypothermia. Although the prognosis is generally favorable, complications such as hypercalcemia, thrombocytopenia, hypoglycemia and hypertriglyceridemia may complicate its course. The most serious complication is hypercalcemia that may reach life threatening levels and can be associated with nephrocalcinosis. We thereby describe a case of subcutaneous fat necrosis after therapeutic hypothermia, which presented with late-onset refractory severe hypercalcemia and persistent nephrocalcinosis during the follow up of the patient. Due to the risk of the development of chronic kidney disease, we highlight the importance of careful monitoring of hypercalcemia and review the literature of subcutaneous fat necrosis related to nephrocalcinosis.

Neonatale subcutane vetnecrose met opvolging van de hypercalciëmie

2021 ◽  
Author(s):  
L. VERBEKE ◽  
K. KAMOEN ◽  
L. AEYELS ◽  
J. VERAMME ◽  
N. DE CONO
Keyword(s):  
Skin Biopsy ◽  
Therapeutic Hypothermia ◽  
Subcutaneous Fat ◽  
Fat Necrosis ◽  
Skin Damage ◽  
Subcutaneous Fat Necrosis ◽  
Life Threatening ◽  
The Right ◽  
Ischemic Encephalopathy

Subcutaneous fat necrosis of the newborn with follow-up of the hypercalcemia A thirteen-day-old boy is diagnosed with subcutaneous fat necrosis of the newborn after the appearance of erythematous, subcutaneous plaques on the right shoulder. This rare, usually self-limiting cutaneous disease is mainly diagnosed in term and postterm infants. The diagnosis is confirmed by a skin biopsy. Various etiological hypotheses are suggested, although the exact pathogenesis needs to be elucidated. The disease might be associated with several maternal and foetal predisposing factors, including therapeutic hypothermia at birth as part of hypoxic ischemic encephalopathy. It is a benign inflammation of the subcutaneous adipocytes that can be accompanied by life-threatening complications, such as hypercalcemia and thrombocytopenia. The latter requires rigorous follow-up and, in some cases, also treatment. The skin damage should only be treated symptomatically with analgesia.

scholarly journals Neonatal hypercalcemia associated with extensive subcutaneous fat necrosis: a case report

2020 ◽  
Vol 7 (7) ◽  
pp. 1641
Author(s):  
Mahmoud M. Osman ◽  
Suzan Abdel Hamid ◽  
Hussein M. Kira ◽  
Adel Abdelsalam Alatar ◽  
Enas M. Elsabagh
Keyword(s):  
Perinatal Asphyxia ◽  
Subcutaneous Fat ◽  
Male Infant ◽  
Spontaneous Resolution ◽  
Stress Factors ◽  
Fat Necrosis ◽  
Fat Tissue ◽  
Subcutaneous Fat Necrosis ◽  
Life Threatening ◽  
Term Newborns

Subcutaneous fat necrosis (SCFN) of the newborn is rare self-limited fat tissue inflammation that usually occurs in term or post-term newborns exposed to perinatal stress factors, such as perinatal asphyxia, meconium aspiration, neonatal sepsis, and therapeutic hypothermia. SCFN usually appears in the first few weeks of life and has a benign course with spontaneous resolution. Monitoring for complications, in particular the potentially life-threatening hypercalcemia, is crucial. In this report, we describe a male infant with extensive SCFN and neonatal hypercalcemia that went through a prolonged course.

Hypercalcemia in Association with Subcutaneous Fat Necrosis of the Newborn: Studies of Calcium-Regulating Hormones

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 93-96 ◽  
Author(s):  
JENNIFER S. COOK ◽  
MARY SEABURY STONE ◽  
JAMES R. HANSEN
Keyword(s):  
Subcutaneous Fat ◽  
Full Term ◽  
Fat Necrosis ◽  
Subcutaneous Fat Necrosis ◽  
Subcutaneous Nodules ◽  
Term Newborns

Subcutaneous fat necrosis of the newborn is an uncommon disorder that occurs during the first few weeks of life as firm subcutaneous nodules on the cheeks, buttocks, back, arms, and thighs. This disorder, which initially was described by Harrison and McNee in 1926,1 typically affects full-term newborns who have experienced perinatal distress. Subcutaneous fat necrosis of the newborn usually resolves over a period of months, but may result in death due to its association with hypercalcemia. The association between subcutaneous fat necrosis of the newborn and hypercalcemia was first reported by Clay in 19562; however, the mechanism that results in hypercalcemia remains incompletely understood.3-7

Subcutaneous fat necrosis, a rare but serious side effect of hypoxic-ischemic encephalopathy and whole-body hypothermia

2019 ◽  
Vol 47 (9) ◽  
pp. 986-990 ◽  
Author(s):  
Mahdi Alsaleem ◽  
Lina Saadeh ◽  
Valerie Elberson ◽  
Vasantha H.S. Kumar
Keyword(s):  
Therapeutic Hypothermia ◽  
Subcutaneous Fat ◽  
Whole Body ◽  
Subcutaneous Fat Necrosis ◽  
P Values ◽  
Life Threatening ◽  
The Mean ◽  
Body Cooling ◽  
Whole Body Cooling ◽  
Ischemic Encephalopathy

Abstract Objective To describe the clinical characteristics and risk factors in infants with subcutaneous fat necrosis (SFN) following therapeutic hypothermia for hypoxic-ischemic encephalopathy (HIE). Methods A case-control study was performed by a retrospective chart review of infants with moderate or severe HIE admitted to a level IV regional perinatal center and who underwent whole-body cooling. Results A total of 14 (8.1%) of 171 infants with moderate or severe HIE who underwent whole-body cooling developed SFN during hospitalization. There were more females [71% (10/14)] and large-for-gestational age (LGA) infants [28% (4/14)] in the SFN group vs. 36% females (57/157) and 8% LGA infants (13/157) in the group without SFN (P-values of 0.009 and 0.015, respectively). The mean lowest platelet count was lower 108 ± 55 109/L vs. 146 ± 62 109/L and the mean highest calcium level was higher 11.3 ± 2.5 vs. 10.6 ± 0.8 mg/dL in infants with SFN vs. infants without SFN, respectively (P-values of 0.0078 and 0.006, respectively). Distribution of skin lesions followed distinctive patterns representing the areas with direct contact with the cooling blanket. One infant developed severe, life-threatening hypercalcemia that required aggressive management, including diuretics, corticosteroids and bisphosphonates. Conclusion Although SFN is a rare complication of therapeutic hypothermia, it can be a life-threatening condition if complicated by severe hypercalcemia. Infants who undergo therapeutic hypothermia for HIE need regular skin examinations to evaluate for SFN. If SFN is identified, monitoring of serum calcium levels to prevent life-threatening hypercalcemia is recommended.

Subcutaneous Fat Necrosis After Moderate Therapeutic Hypothermia in Neonates

PEDIATRICS ◽  
2011 ◽  
Vol 128 (2) ◽  
pp. e450-e452 ◽  
Author(s):  
B. Strohm ◽  
A. Hobson ◽  
P. Brocklehurst ◽  
A. D. Edwards ◽  
D. Azzopardi ◽  
...  
Keyword(s):  
Therapeutic Hypothermia ◽  
Subcutaneous Fat ◽  
Fat Necrosis ◽  
Subcutaneous Fat Necrosis

scholarly journals Pamidronate as first-line treatment of hypercalcemia in neonatal subcutaneous fat necrosis: A case series

2019 ◽  
Author(s):  
Alexander D Chesover ◽  
Jennifer Harrington ◽  
Farid H Mahmud
Keyword(s):  
Serum Calcium ◽  
Subcutaneous Fat ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Bisphosphonate Therapy ◽  
Fat Necrosis ◽  
First Line ◽  
Retrospective Case ◽  
Subcutaneous Fat Necrosis ◽  
Severe Hypercalcemia

Abstract Background Subcutaneous fat necrosis (SCFN) can be complicated by severe hypercalcemia, which is frequently asymptomatic. Nephrocalcinosis is associated with hypercalcemia and, in other clinical settings, has been linked to furosemide and glucocorticoid use. First-line bisphosphonate therapy treating hypercalcemia in neonatal SCFN is not well described. Objectives To describe the biochemical changes and risk of nephrocalcinosis in infants with hypercalcemia, secondary to neonatal SCFN, treated with initial pamidronate. Methods A retrospective chart review of five infants treated with initial pamidronate and without furosemide or glucocorticoids. Data were collected on the following: timing of presentation, therapeutic response, and presence of nephrocalcinosis. Results Hypercalcemia resolved after 2.8±1.7 days; this is compared to 7.6±2.8 days from previously reported cases utilising alternative therapies (P=0.012). There were no episodes of rebound hypercalcemia or hypocalcemia. Nephrocalcinosis was present in four of five cases. When including published cases, age at diagnosis was associated with presenting serum calcium (P=0.003) and nephrocalcinosis was associated with higher serum calcium (P=0.014) and time from SCFN to hypercalcemia diagnosis (P=0.002). Conclusions This retrospective case series demonstrates that first-line pamidronate treatment was effective and safe in the resolution of hypercalcemia. Nephrocalcinosis was observed, despite the avoidance of furosemide and glucocorticoid therapy, and associated with greater disease severity and duration of hypercalcemia.

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