Presentation
Abstract A neonate, born from a mother with hypertension during the last trimester of gestation, presented with ulcerated lesions on the right lower limb that had been present since birth. [ncbi.nlm.nih.gov]
We describe a case of newborn affected with the disease, its presentation, clinical course, and treatment. Article Access Statistics Viewed 155 PDF Downloaded 9 [ijpd.in]
Entire Body System
- Hypothermia
Hypothermia as a risk factor for subcutaneous fat necrosis is reviewed. Clinicians should be aware of subcutaneous fat necrosis as a possible risk factor and complication associated with asphyxiated newborns who may undergo therapeutic hypothermia. [ncbi.nlm.nih.gov]
Our data suggest that prolonged moderate hypothermia is an actual risk factor for subcutaneous fat necrosis. [pediatrics.aappublications.org]
- Hypoxemia
It usually presents in neonates who have experienced perinatal difficulty such as asphyxia, peripheral hypoxemia, hypothermia, meconium aspiration or trauma. [ncbi.nlm.nih.gov]
The girl remained 10 days in the neonatal unit due to hypoxemia with supplemental O2 requirement, and she received intravenous antibiotic treatment for suspected sepsis. [endopedonline.com.ar]
The exact etiopathogenesis is unclear but most infants suffer from some form of perinatal difficulty that includes asphyxia, peripheral hypoxemia, meconium aspiration or trauma; it is also seen in association with maternal diabetes. [clinicalgate.com]
Fig(1,2) DISCUSSION SCFN is an inflammatory disorder of the adipose tissue which mostly occurs in term or post term neonates with perinatal stress such as hypoxemia, hypothermia, Rh incompatibility, obstetric trauma and some of maternal disorders such [pjms.com.pk]
It is partly associated with the perinatal ischemia/hypoxemia itself and with the resolution of the skin lesions with accompanying endocrinological changes. SCFN is self-healing, sometimes with residua such as skin atrophy and scarring [ 7, 9, 10 ]. [bmcpediatr.biomedcentral.com]
Musculoskeletal
- Symmetrical Arthritis
Abstract An 82-year-old man presented with a two-week history of three painful, inflamed nodules on his lower extremities with symmetric arthritis of multiple joints. [ncbi.nlm.nih.gov]
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
- Encephalopathy
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]
Blood calcium levels need to be monitored in affected infants. hypothermia encephalopathy hypercalcemia Accepted April 7, 2011. [pediatrics.aappublications.org]
- Focal Seizure
On the first day of life he had a focal seizure following hypocalcaemia which was treated with phenobarbital and calcium gluconate up to normalization of calcium level. On 45th day he was admitted with fever, poor feeding and subcutaneous nodules. [pjms.com.pk]
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]
X-Ray
- Soft Tissue Calcification
In this case, the radiographic demonstration of soft-tissue calcification revealed the skin calcification in the absence of clinical signs of SCFN and without hypercalcaemia in the first 48 h of life. [ncbi.nlm.nih.gov]
Congenital causes of soft tissue calcification can also be excluded because calcification of the atrial septum was not seen at the initial echocardiographic examination. [fn.bmj.com]
Some degree of subcutaneous atrophy is common. [23] Soft tissue calcification may last for years. [emedicine.com]
Urine
- Pyuria
Pyuria (20- 25 WBC / HPF), hypercalcaemia (ca = 13.5mg/dl, P = 3.5mg/dl, Alk .ph = 326), hyperammonia (160mg/dl), hyperuricemia (7.2mg/dl), hypertriglyceridemia (415mg/dl) were detected as abnormal laboratory findings. [pjms.com.pk]
Serum
- Base Deficit
The cord arterial pH was 6.85 and the base deficit 18.1 mmol/l. Blood cultures were drawn, and the infant received amoxicillin and gentamicin. A chest radiograph showed cardiac enlargement with clear lung fields. [fn.bmj.com]
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]