Hypocalcemia Associated with Subcutaneous Fat Necrosis of the Newborn: Case Report and Literature Review
Subcutaneous fat necrosis of the newborn (SCFNN) is a rare benign inflammatory disorder of the adipose tissue but may be complicated by hypercalcemia or less frequently, hypocalcemia, resulting in morbidity and mortality. Here we report the case of a neonate with subcutaneous fat necrosis who surpri...
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| Format: | Article |
| Language: | English |
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Oman Medical Specialty Board
2017-11-01
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| Series: | Oman Medical Journal |
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| Online Access: | http://omjournal.org/articleDetails.aspx?coType=1&aId=2060 |
| _version_ | 1819095971682844672 |
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| author | Alphonsus N. Onyiriuka Theodora E. Utomi |
| author_facet | Alphonsus N. Onyiriuka Theodora E. Utomi |
| author_sort | Alphonsus N. Onyiriuka |
| collection | DOAJ |
| description | Subcutaneous fat necrosis of the newborn (SCFNN) is a rare benign inflammatory disorder of the adipose tissue but may be complicated by hypercalcemia or less frequently, hypocalcemia, resulting in morbidity and mortality. Here we report the case of a neonate with subcutaneous fat necrosis who surprisingly developed hypocalcemia instead of hypercalcemia. A full-term female neonate was delivered by emergency cesarean section for fetal distress and was subsequently admitted to the Special Care Baby Unit. The mother’s pregnancy was uncomplicated up to delivery. Her anthropometric measurements were birth weight 4.1 kg (95th percentile), length 50 cm (50th percentile), and head circumference 34.5 cm (50th percentile). The Apgar scores were 2, 3, and 8 at 1, 5, 10 minutes, respectively. There was no abnormal facies and she was fed with breast milk only. On the seventh day of life, the infant was found to have multiple nodules located in the neck, upper back, and right arm. The nodules were firm, well circumscribed with no evidence of tenderness. Her total serum calcium level was 1.55 mmol/L (normal range 2.2 to 2.7 mmol/L) and this was associated with hypotonia and poor sucking reflex. The packed cell volume was 40%. The serum albumin and blood glucose levels were normal. Her blood culture was sterile. A clinical diagnosis of hypocalcemia associated with SCFNN was made. The infant was treated for hypocalcemia (using calcium gluconate) and was carefully followed-up. The skin lesions resolved completely three months after their eruption. Repeat serum calcium measurements at three, six, and nine months of age were all within normal limits. Although SCFNN is a rare benign clinical condition, it may be complicated by hypocalcemia. Therefore, periodic measurements of the serum calcium levels is warranted in such a patient, beginning from the neonatal period up to the age of six months. |
| first_indexed | 2024-12-21T23:51:47Z |
| format | Article |
| id | doaj.art-02c16948f10243d883f25127d8d1ed80 |
| institution | Directory Open Access Journal |
| issn | 1999-768X 2070-5204 |
| language | English |
| last_indexed | 2024-12-21T23:51:47Z |
| publishDate | 2017-11-01 |
| publisher | Oman Medical Specialty Board |
| record_format | Article |
| series | Oman Medical Journal |
| spelling | doaj.art-02c16948f10243d883f25127d8d1ed802022-12-21T18:45:54ZengOman Medical Specialty BoardOman Medical Journal1999-768X2070-52042017-11-0132651852110.5001/omj.2017.99Hypocalcemia Associated with Subcutaneous Fat Necrosis of the Newborn: Case Report and Literature ReviewAlphonsus N. Onyiriuka0Theodora E. Utomi1Endocrine and Metabolic Unit, Department of Child Health, University of Benin Teaching Hospital, Benin City, NigeriaSpecial Care Baby Unit, Department of Nursing Services, St Philomena Catholic Hospital, Benin City, NigeriaSubcutaneous fat necrosis of the newborn (SCFNN) is a rare benign inflammatory disorder of the adipose tissue but may be complicated by hypercalcemia or less frequently, hypocalcemia, resulting in morbidity and mortality. Here we report the case of a neonate with subcutaneous fat necrosis who surprisingly developed hypocalcemia instead of hypercalcemia. A full-term female neonate was delivered by emergency cesarean section for fetal distress and was subsequently admitted to the Special Care Baby Unit. The mother’s pregnancy was uncomplicated up to delivery. Her anthropometric measurements were birth weight 4.1 kg (95th percentile), length 50 cm (50th percentile), and head circumference 34.5 cm (50th percentile). The Apgar scores were 2, 3, and 8 at 1, 5, 10 minutes, respectively. There was no abnormal facies and she was fed with breast milk only. On the seventh day of life, the infant was found to have multiple nodules located in the neck, upper back, and right arm. The nodules were firm, well circumscribed with no evidence of tenderness. Her total serum calcium level was 1.55 mmol/L (normal range 2.2 to 2.7 mmol/L) and this was associated with hypotonia and poor sucking reflex. The packed cell volume was 40%. The serum albumin and blood glucose levels were normal. Her blood culture was sterile. A clinical diagnosis of hypocalcemia associated with SCFNN was made. The infant was treated for hypocalcemia (using calcium gluconate) and was carefully followed-up. The skin lesions resolved completely three months after their eruption. Repeat serum calcium measurements at three, six, and nine months of age were all within normal limits. Although SCFNN is a rare benign clinical condition, it may be complicated by hypocalcemia. Therefore, periodic measurements of the serum calcium levels is warranted in such a patient, beginning from the neonatal period up to the age of six months.http://omjournal.org/articleDetails.aspx?coType=1&aId=2060HypocalcemiaInfantNewbornSubcutaneous Fat NecrosisPerinatal Stress |
| spellingShingle | Alphonsus N. Onyiriuka Theodora E. Utomi Hypocalcemia Associated with Subcutaneous Fat Necrosis of the Newborn: Case Report and Literature Review Oman Medical Journal Hypocalcemia Infant Newborn Subcutaneous Fat Necrosis Perinatal Stress |
| title | Hypocalcemia Associated with Subcutaneous Fat Necrosis of the Newborn: Case Report and Literature Review |
| title_full | Hypocalcemia Associated with Subcutaneous Fat Necrosis of the Newborn: Case Report and Literature Review |
| title_fullStr | Hypocalcemia Associated with Subcutaneous Fat Necrosis of the Newborn: Case Report and Literature Review |
| title_full_unstemmed | Hypocalcemia Associated with Subcutaneous Fat Necrosis of the Newborn: Case Report and Literature Review |
| title_short | Hypocalcemia Associated with Subcutaneous Fat Necrosis of the Newborn: Case Report and Literature Review |
| title_sort | hypocalcemia associated with subcutaneous fat necrosis of the newborn case report and literature review |
| topic | Hypocalcemia Infant Newborn Subcutaneous Fat Necrosis Perinatal Stress |
| url | http://omjournal.org/articleDetails.aspx?coType=1&aId=2060 |
| work_keys_str_mv | AT alphonsusnonyiriuka hypocalcemiaassociatedwithsubcutaneousfatnecrosisofthenewborncasereportandliteraturereview AT theodoraeutomi hypocalcemiaassociatedwithsubcutaneousfatnecrosisofthenewborncasereportandliteraturereview |