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Updated: Oct 5, 2026
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Calcinosis cutis following extravasation of calcium gluconate in neonates
1Department of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Insights
Subcutaneous calcium deposition, a rare complication of calcium gluconate treatment for neonatal hypocalcemia, can cause skin issues and joint contractures. However, infants typically recover fully with supportive care.
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
- Dermatology
Background:
- Neonatal hypocalcemia is common, particularly in premature infants.
- Intravenous calcium gluconate is the standard treatment.
- Subcutaneous calcium deposition is a potential adverse effect.
Purpose of the Study:
- To report on subcutaneous calcium deposition following calcium gluconate treatment in neonates.
- To describe the clinical presentation, radiographic findings, and outcomes.
Main Methods:
- Retrospective case series of nine neonates treated with calcium gluconate.
- Clinical observation and radiographic studies.
- Follow-up assessment of recovery.
Main Results:
- Nine neonates developed subcutaneous calcium deposition after calcium gluconate infusion.
- Onset was 5-11 days post-treatment.
- Complications included localized masses, joint contractures, and remote calcification.
- Radiography confirmed extravasation and calcification extent.
Conclusions:
- Subcutaneous calcium deposition is a notable complication of neonatal calcium gluconate therapy.
- Supportive management and skin grafting may be necessary.
- Complete functional recovery is expected, though cosmetic sequelae may persist.
Abstract:
Neonatal hypocalcemia is not an uncommon condition, especially in the premature neonate. It is effectively treated by intravenous infusion with calcium gluconate. We treated nine neonates with subcutaneous calcium deposition following calcium replacement with calcium gluconate from Jan. 1997 to Dec. 1997. Three of the infants were born to diabetic mothers, two had perinatal asphyxia and four were born prematurity. The average dosing number was 7.4 (5 to 9 doses). The onset of calcinosis cutis was 5 to 11 days after the first dose. The replacement of calcium gluconate caused amorphous masses at the site of extravasation and contracture of joint movement. A radiographic study was performed to determine the extent and course of extravasation, and areas remote from the infusion site also showed calcification. There is no specific mode of treatment except supportive management and a skin graft. The patient could functionally recover with cosmetic residue. In our follow-up clinics, all infants completely recovered without functional limitations.
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