Presentation
It usually presents in neonates who have experienced perinatal difficulty such as asphyxia, peripheral hypoxemia, hypothermia, meconium aspiration or trauma. [ncbi.nlm.nih.gov]
Entire Body System
- Swelling
The swelling became progressively worse and the patient was referred to King Faisal Specialist Hospital and Research Centre for further evaluation. [annsaudimed.net]
Also found in: Dictionary, Thesaurus, Legal, Encyclopedia. subcutaneous fat necrosis subcutaneous beneath the layers of the skin. subcutaneous abscess the commonest site of an abscess; causes local pain and swelling and a positive indication is obtained [medical-dictionary.thefreedictionary.com]
One month before admission pain and swelling appeared in the distal half of the left great toe, and two weeks later the [jamanetwork.com]
At the 10 th day, diffuse erythema and subcutaneous swelling were noticed in the posterior thoracic, lumbal, and sacral regions with the involvement of bilateral buttocks. [jcnonweb.com]
The resulting swelling is referred to as a 'pseudo-lipoma'. [ 7 ] Liposarcoma Malignancy is rare but can be found in a lesion with the clinical appearance of a lipoma. [patient.info]
- Malaise
Subcutaneous Fat Necrosis of the Newborn: A Case Report of a Term Infant Presenting with Malaise and Fever at Age of 9 Weeks. Case Rep Pediatr. 2015. 2015:638962. [Medline]. Carraccio C, Papadimitriou J, Feinberg P. [emedicine.com]
It is often accompanied with fever, malaise, and arthralgia. Histologically, the lesions show neutrophilic infiltrates superimposed on chronic multibacillary leprosy. [ijdpdd.com]
- Weight Loss
If mild hypercalcaemia is present, symptoms may be absent, or the child may display irritability, weight loss, apathy, or hypotonia. Another known complication of SCFN is thrombocytopenia. [fn.bmj.com]
Gastrointestinal
- Failure to Thrive
Risk factors identified were newborn failure to thrive (12/16), forceps delivery (7/16), maternal high blood pressure (3/10) and/or diabetes (2/10), and newborn cardiac surgery (1/16). [ncbi.nlm.nih.gov]
A 6-week-old female infant was admitted to our department due to failure to thrive, irritability and vomiting. [paedcro.com]
Other symptoms of hypercalcemia are usually non-specific and consist of fever, vomiting, lethargy, constipation, feeding difficulties, and failure to thrive. [clinicalgate.com]
Nephrocalcinosis without evidence of adverse renal outcomes has been reported to persist up to 4 years after follow-up. [25] Rarely, significant morbidity (seizures, blindness, failure to thrive) and even mortality (from infection and cardiac arrest) [emedicine.com]
Skin
- Subcutaneous Mass
A physical examination revealed a well-mobile, large, soft subcutaneous mass in the right side of his back ( Figure 1 ). [omicsonline.org]
Neurologic
- Seizure
Hypercalcemia may develop and has been implicated as the cause of serious complications including seizures, nephrocalcinosis, and death. [ncbi.nlm.nih.gov]
Hypercalcaemia can be a major complication, usually occurring within the first 6 months of birth and this may result in irritability, constipation, nephrocalcinosis, seizures and sometimes even death. [endocrine-abstracts.org]
Hypercalcemia, the most serious potential complication, carries a risk of intellectual impairment, calcification of soft tissues, seizures, cardiac arrest, renal failure and death. [nature.com]
In cases of severe hypercalcemia seizures and death may ensue, in addition to nephrocalcinosis and hypercalciuria. [clinicalgate.com]
- Lethargy
Although most cases of SCFN resolve spontaneously, SCFN may be associated with symptomatic hypercalcemia presenting as lethargy, hypotonia, irritability, vomiting, polyuria, polydipsia, constipation, and dehydration. [ijpd.in]
Other symptoms of hypercalcemia are usually non-specific and consist of fever, vomiting, lethargy, constipation, feeding difficulties, and failure to thrive. [clinicalgate.com]
Hypocalcaemia and rarely hypercalcaemia are considered as major causes of morbidity and mortality in cases of SCFN. 1-4 Hypercalcaemia could be presented with lethargy, hypotonia, polyuria, polydipsia, dehydration, constipation, FTT and even sudden death [pjms.com.pk]
The clinical manifestations are hypothermia associated with lethargy and generalized pitting edema of the skin simulating sclerema neonatorum. Etiology Exposure to cold. Intrauterine growth retardation, which results in a relatively thin panniculus. [drmhijazy.com]
- Apathy
If mild hypercalcaemia is present, symptoms may be absent, or the child may display irritability, weight loss, apathy, or hypotonia. Another known complication of SCFN is thrombocytopenia. [fn.bmj.com]
Workup
Our case highlights the importance of remaining vigilant in the workup of atypical rashes of the infant, which should include early assessment of serum electrolytes. [ncbi.nlm.nih.gov]
Treatment
We herein present a case of a newborn who developed subcutaneous fat necrosis-related hypercalcemia after hypothermia treatment for hypoxic ischemic encephalopathy. [ncbi.nlm.nih.gov]
Prognosis
The prognosis of the disease is generally good, but it may be complicated by potentially life-threatening metabolic alterations, including hypercalcemia, thrombocytopenia, hypoglycemia, and hypertriglyceridemia. [ncbi.nlm.nih.gov]
Etiology
Extensive evaluation for the electrolyte disturbances revealed no other etiology. This case reinforces that SCFN should be considered in newborns with hypercalcemia of unknown etiology. [ncbi.nlm.nih.gov]
Clinical Features: Indurated erythematous or violaceous nodules of unknown etiology appearing in the first few weeks of life Affects full-term or post-term infants. [dermpedia.org]
Etiology Different predisposing factors play an important role in the etiology of subcutaneous fat necrosis of the newborn. [drmhijazy.com]
We need to emphasize greater awareness of the possibility of abuse in children who present for medical care when the etiology is obscure. [annsaudimed.net]
Epidemiology
Epidemiology [ 1 ] Lipomas may be seen in all age groups, but usually first appear between 40 and 60 years of age. Solitary lipomas are more common in women. Multiples - referred to as lipomatosis - are more common in men. [patient.info]
We can't do much more," Carlo La Vecchia, head of epidemiology at the University of Milan, said in an interview. "It's time to move on to other things." La Vecchia spoke Thursday at a European breast cancer conference in Barcelona. [feliciaenache.blogspot.com]
[…] maternal hypercoagulable state such as protein C deficiency and antiphospholipid syndrome. [23] Local pressure trauma during delivery from forceps, from prolonged labor, and from being large for gestational age (macrosomia) may play a role. [20, 21] Epidemiology [emedicine.com]
References Richardson T Kerr D 2003 Skin-related complications of insulin therapy, epidemiology and emerging management strategies. [edmcasereports.com]
Pathophysiology
Pathophysiology may include enhanced gastrointestinal calcium absorption and bone resorption. We treated an infant with SFN and serum calcium of 15 mg/dL with prednisolone and low‐dose zoledronic acid. [ingentaconnect.com]
DISCUSSION SCFN is a rare, often painful condition of unknown pathophysiology. [fn.bmj.com]
The pathophysiology of hypercalcaemia is not known completely but calcium release from necrotic fat cells and production of 1, 25 (OH) 2 vit D from granulomatous cells (like macrophages) result to prostaglandin production which increases osteoclatsic [pjms.com.pk]
Subcutaneous fat necrosis of the newborn usually runs a self-limited course, but it may be complicated by hypercalcemia and other metabolic abnormalities. [1, 2] Pathophysiology The exact pathogenesis of subcutaneous fat necrosis of the newborn (SFNN) [emedicine.com]
Prevention
Although patients need long-term follow-up to prevent hypercalcemia, the prognosis is generally favorable. [ncbi.nlm.nih.gov]
The early diagnosis and prompt treatment of hypercalcemia are essential to prevent severe complications. Keywords: Hypercalcemia; Fat Necrosis; Infant, Newborn; Nephrocalcinosis; Subcutaneous Fat. Refbacks There are currently no refbacks. [actamedicaportuguesa.com]