Endocrine Abstracts

Subcutaneous fat necrosis (ScFN) of the newborn is an uncommon self-limiting panniculitis, often associated with a complicated delivery. 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. Treatment options are variable with a number of different regimens including intravenous fluids, loop diuretics, prednisolone and bisphosphonates having been described in the literature. We report a series of five neonates who presented recently with ScFN and related hypercalcaemia.

All five patients were born after a difficult delivery and each manifested varying degrees of hypercalcaemia. One neonate had mildly elevated calcium levels (2.72 mmol/l) and was monitored with no further intervention required. Two were managed effectively with the use of low calcium milk feeds and the remaining two received intravenous hydration and multiple pamidronate infusions (peak calcium levels were 3.09, 3.13 mmol/l respectively). One patient in this series was diagnosed with ScFN and discharged home with no investigations or follow up and was subsequently readmitted with hypercalcaemia that required active treatment.

Our unit’s experience reiterates the importance of monitoring calcium levels in all neonates with ScFN and highlights a management strategy, which successfully minimises significant co-morbidities.