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Oral clodronate therapy for hypercalcemia related to extensive subcutaneous fat necrosis in a newborn

Shuo-Hsun Hung1, Wen-Yu Tsai, Po-Nien Tsao

  • 1Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|January 16, 2004
PubMed

Insights

This study shows oral clodronate effectively treated severe hypercalcemia in a newborn with subcutaneous fat necrosis when standard therapies failed. This bisphosphonate offers a new treatment option for this rare condition.

Area of Science:

  • Neonatal Medicine
  • Pediatric Endocrinology
  • Pharmacology

Background:

  • Subcutaneous fat necrosis in newborns can lead to life-threatening hypercalcemia.
  • Bisphosphonates are emerging as a treatment for this condition.

Observation:

  • A female infant presented with extensive subcutaneous fat necrosis and intractable hypercalcemia.
  • Standard hypercalcemia treatments (hydration, diet, furosemide, glucocorticoids) were ineffective.

Findings:

  • Elevated 1,25-dihydroxyvitamin D and suppressed parathyroid hormone confirmed the hypercalcemia mechanism.
  • Oral clodronate disodium administration normalized serum calcium and related biomarkers.
  • Key markers including serum calcium, urine N-telopeptide, urine calcium/creatinine ratio, and intact parathyroid hormone returned to normal levels.

Implications:

  • Oral clodronate may be a viable and effective treatment for neonatal hypercalcemia associated with subcutaneous fat necrosis.
  • This case highlights the potential of bisphosphonates in managing refractory hypercalcemia in neonates.
  • Further research into bisphosphonate efficacy for neonatal subcutaneous fat necrosis is warranted.

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