European Journal of Pediatrics

, Volume 167, Issue 12, pp 1459–1461 | Cite as

Severe neonatal hypercalcemia caused by subcutaneous fat necrosis without any apparent cutaneous lesion

  • Laurent Bonnemains
  • Stephanie Rouleau
  • Gaelle Sing
  • Claude Bouderlique
  • Regis Coutant
Short Report

Abstract

Subcutaneous fat necrosis is a classic, albeit uncommon, cause of neonatal hypercalcemia. It occurs in newborn infants within the first month of life following a complicated delivery. The diagnosis is usually easy because of the presence of red-purple plaques in fatty areas along with firm subcutaneous nodules. A 1-month-old neonate, born strangled by her umbilical cord, presented with diarrhea and hypercalcemia (3.46 mM) with an initial physical examination considered normal. Her biological evaluations were as follows: P = 1.37 mM (1.6–2.2); PTH = 3 ng/L (12–65); 25-OH vitamin D = 87 nM (23–113); (1,25)-OH2 vitamin D = 192 ng/L (20–46). The third day, a careful exam of the whole cutaneous surface revealed small firm subcutaneous nodules in the ischial region. Despite the absence of any visible skin modification, the association of perinatal stress and high (1,25)-OH2 vitamin D level with subcutaneous nodules led to the diagnosis of subcutaneous fat necrosis. She was treated with oral prednisone for 45 days. Serum calcium levels normalized within a week, and the nodules disappeared without complications. Conclusion: Subcutaneous fat necrosis may induce severe hypercalcemia without any visible cutaneous lesion.

Keywords

Newborn Hypercalcemia Subcutaneous fat necrosis 

Abreviations

mM

Millimole per liter

nM

Nanomole per liter

CRP

C-reactive protein

SCFN

Subcutaneous fat necrosis

PTH

Parathyroid hormone

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Laurent Bonnemains
    • 1
  • Stephanie Rouleau
    • 1
  • Gaelle Sing
    • 2
  • Claude Bouderlique
    • 1
  • Regis Coutant
    • 3
  1. 1.NéonatalogieCHU AngersAngersFrance
  2. 2.PédiatrieCH LavalLavalFrance
  3. 3.Endocrinologie pédiatriqueCHU AngersAngersFrance

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