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Case Reports
. 2022;22(1):98-103.
doi: 10.24911/SJP.106-1602681630.

The cause of severe hypercalcaemia resistant to pamidronate treatment: subcutaneous fat necrosis with no visible skin lesion

Saime Ergen Dibeklioğlu  1 , Veysel Nijat Baş  2 , Emine Esin Yalınbaş  2 , Sermin Tok Umay  2
Affiliations
Case Reports

The cause of severe hypercalcaemia resistant to pamidronate treatment: subcutaneous fat necrosis with no visible skin lesion

Saime Ergen Dibeklioğlu et al. Sudan J Paediatr. 2022.

Abstract

Subcutaneous fat necrosis (SCFN) is an uncommon cause of neonatal hypercalcaemia. It is usually seen in neonates after a complicated delivery within the first month of life. While uncommon, hypercalcaemia can be fatal. It is characterised by red-purple plaques in fatty points along with firm subcutaneous nodules. Rarely, SCFN may cause severe hypercalcaemia with no visible skin lesion. In this rare case, we report severe infancy hypercalcaemia without characteristic skin lesion on first physical examination, unresponsive to hydration, diuretic, prednisolone and standard dose of pamidronate treatment. As timely diagnosis and treatment are so important, this complication should be kept in mind even in such clinical presentations.

Keywords: Hypercalcaemia; Infant; Pamidronate; Subcutaneous fat necrosis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Nodular lesion under the right scapula detected with careful palpation.
Figure 2.
Figure 2.
Calcific focus with an approximately 8 mm diameter hypereoic shadow on the posterior ultrasound.
Figure 3.
Figure 3.
Bilateral nephrocalcinosis on ultrasonography.
See this image and copyright information in PMC

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