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Calcium management challenges in a macrosomic child with subcutaneous fat necrosis

Daniel Chan1, Wilsie Martillano Salas-Walinsundin2, Fabian Kok Peng Yap3

  • 1Paediatric Medicine, KK Women's and Children's Hospital, Singapore.

BMJ Case Reports
|February 22, 2019
PubMed

Insights

Managing infants with maternal gestational diabetes and subcutaneous fat necrosis requires close monitoring of calcium levels. Initial hypocalcemia can shift to hypercalcemia due to inflammation, necessitating careful management.

Area of Science:

  • Neonatal Medicine
  • Endocrinology
  • Pediatric Case Study

Background:

  • Maternal gestational diabetes mellitus (GDM) can impact neonatal health.
  • Subcutaneous fat necrosis (SCFN) is a rare neonatal condition.
  • Calcium homeostasis is critical in newborns.

Observation:

  • A case of neonatal SCFN in an infant born to a mother with GDM is presented.
  • The infant experienced significant fluctuations in serum calcium levels.
  • Initial hypocalcemia was observed, requiring calcium replacement.

Findings:

  • Functional hypoparathyroidism contributed to initial hypocalcemia.
  • Granulomatous inflammation in SCFN led to increased extrarenal production of 1,25-dihydroxyvitamin D.
  • This resulted in subsequent hypercalcemia.

Implications:

  • SCFN typically has a self-limiting course with a good prognosis.
  • Aberrations in serum calcium, including hypocalcemia and hypercalcemia, can pose life-threatening risks.
  • Close monitoring of calcium levels is crucial in managing these infants.

Keywords:
calcium and bonedermatologyendocrinologyneonatal health

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