Hypercalcemia and metastatic calcification in a neonate with subcutaneous fat necrosis

Nair, Sreeja C.; Nair, Sathyajith; Borade, Ashwin; Ramakrishnan, KG

doi:10.1007/s12098-009-0278-8

Cited by 7 publications

(8 citation statements)

References 3 publications

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“…Some authors reported an association with elevated prostaglandin levels that can lead to osteoclast activation and calcium release from granulomas or necrotic fat [37]. For others, hypercalcemia is believed to be caused by an excessive extra renal production of 1,25-dihydroxyvitamin D [17,33,34,36,38] by the granulomatous macrophages, as observed in other granulomatous inflammations, such as sarcoidosis [39] which increases the intestinal calcium uptake [20]. These complications were not detected in our patients.…”

Section: Filippi Et Al the Journal Of Maternal-fetal And Neonatalmentioning

confidence: 48%

“…It usually occurs between 2 and 16 weeks, when SFN begins to resolve and may either be asymptomatic or manifest with failure to thrive, lethargy, irritability, hypotonia, vomiting and, in severe cases, calcification of the soft tissues. Nephrolithiasis, nephrocalcinosis, renal failure, metastatic calcification in the pericardium and brain, and also cardiac arrest have been described [34][35][36]. Some authors reported an association with elevated prostaglandin levels that can lead to osteoclast activation and calcium release from granulomas or necrotic fat [37].…”

Section: Filippi Et Al the Journal Of Maternal-fetal And Neonatalmentioning

confidence: 99%

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Strategies for reducing the incidence of skin complications in newborns treated with whole-body hypothermia

Filippi

Catarzi

Padrini

et al. 2012

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective: To present the results of a strategy designed to reduce the incidence of skin complications in newborns with hypoxicischemic encephalopathy treated with moderate whole-body hypothermia. Design: Retrospective study. Setting: Neonatal Intensive Care Unit (NICU). Patients: Thirty-nine neonates cooled in the considered period. Intervention: Starting from January 2008, for neonates treated with moderate whole-body hypothermia (33.5 °C), the cooling system was set in "automatic servo-controlled mode (ACM)", where the temperature of the circulating water could vary between 4 °C and 42 °C. Starting from January 2009, cooling blankets were used in another type of automatic mode, the "gradient variable mode (GVM)", where the circulating water was maintained at a specific pre-set gradient towards the patient's body temperature, and a specific nursing protocol (NP) was adopted. Measurements and main results: Two of the eleven newborns treated with the "ACM" exhibited skin complications compatible with subcutaneous fat necrosis (SFN). None of the twenty-eight newborns treated with the "GVM" exhibited skin complications. A comparison of the biochemical and hematological data between these two groups revealed that newborns treated after the adopting of a NP and the "GVM" showed lower serum protein C and calcium levels, and higher platelet levels. Conclusions: Our data suggest that newborns undergoing therapeutic cooling may benefit from a specific NP and correct cooling unit setting. Should further studies confirm our data, this nursing approach could be easily adopted.

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Section: Filippi Et Al the Journal Of Maternal-fetal And Neonatalmentioning

confidence: 48%

Section: Filippi Et Al the Journal Of Maternal-fetal And Neonatalmentioning

confidence: 99%

Strategies for reducing the incidence of skin complications in newborns treated with whole-body hypothermia

Filippi

Catarzi

Padrini

et al. 2012

The Journal of Maternal-Fetal & Neonatal Medicine

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“…Nair et al [140] reported a 30-day-old infant with subcutaneous fat necrosis and symptomatic hypercalcemia, who developed metastatic calcification in the subcutaneous tissue, kidneys, pericardium and brain. The infant had anemia, hypertriglyceridemia and hypercholesterolemia.…”

Section: Resultsmentioning

confidence: 99%

Clinical Pharmacology of Furosemide in Neonates: A Review

Pacifici

2013

Pharmaceuticals

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Furosemide is the diuretic most used in newborn infants. It blocks the Na+-K+-2Cl− symporter in the thick ascending limb of the loop of Henle increasing urinary excretion of Na+ and Cl−. This article aimed to review the published data on the clinical pharmacology of furosemide in neonates to provide a critical, comprehensive, authoritative and, updated survey on the metabolism, pharmacokinetics, pharmacodynamics and side-effects of furosemide in neonates. The bibliographic search was performed using PubMed and EMBASE databases as search engines; January 2013 was the cutoff point. Furosemide half-life (t1/2) is 6 to 20-fold longer, clearance (Cl) is 1.2 to 14-fold smaller and volume of distribution (Vd) is 1.3 to 6-fold larger than the adult values. t1/2 shortens and Cl increases as the neonatal maturation proceeds. Continuous intravenous infusion of furosemide yields more controlled diuresis than the intermittent intravenous infusion. Furosemide may be administered by inhalation to infants with chronic lung disease to improve pulmonary mechanics. Furosemide stimulates prostaglandin E2 synthesis, a potent dilator of the patent ductus arteriosus, and the administration of furosemide to any preterm infants should be carefully weighed against the risk of precipitation of a symptomatic patent ductus arteriosus. Infants with low birthweight treated with chronic furosemide are at risk for the development of intra-renal calcifications.

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“…Con respecto al EN entre los factores de riesgo descritos están: RN muy graves, prematuros con bajo peso al nacer, sepsis, cardiopatías congénitas, entre otras 18 . Se asocia con una alta tasa de mortalidad, alrededor del 75% 19 .…”

Section: Discussionunclassified

Necrosis grasa del recién nacido

et al. 2020

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Introducción: Las paniculitis constituyen un grupo de enfermedades que afectan al tejido graso subcutáneo y se manifiestan clínicamente como nódulos. Su patogenia no es del todo clara, por lo general es asintomático. El diagnóstico confirmatorio es histológico.Objetivo: describir las características clínicas e histopatológicas de un caso de necrosis grasa, una forma especifica de paniculitis en el recién nacido (RN).Caso Clínico: RN femenino de 40 semanas, parto cesárea de urgencia por taquicardia fetal más meconio, APGAR 7-8-9. Requirió oxigeno y presión positiva por 5 min. Al quinto día de vida presentó aumento de volumen en tronco posterior, de coloración eritematosa - violácea, remitente a la palpación, no doloroso. Ecotomografría de piel y partes blandas informó aumento de la ecogenecidad del tejido celular subcutáneo y pérdida de definición de las celdillas adiposas de aproximadamente 42.3 x 9.7 x 20.1 mm, sin presencia de vascularización. Biopsia de piel: epidermis con acantosis irregular y ortoqueratosis en cestas; dermis papilar con infiltrado inflamatorio y dermis reticular y tejido adiposo con presencia de infiltrado linfohistocitiario con tendencia a la formación de nódulos, sin compromiso vascular, leves depósitos de colesterol; compatible con necrosis grasa del recién nacido (NGRN). Paciente tuvo regresión completa de la lesión a los tres meses de vida.Conclusiones: se describe un caso compatible clínica e histológicamente con NGRN; sin complicaciones durante su observación. Por lo general esta patología tiene buen pronóstico, con resolución espontánea, como en nuestro caso.

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Hypercalcemia and metastatic calcification in a neonate with subcutaneous fat necrosis

Cited by 7 publications

References 3 publications

Strategies for reducing the incidence of skin complications in newborns treated with whole-body hypothermia

Strategies for reducing the incidence of skin complications in newborns treated with whole-body hypothermia

Clinical Pharmacology of Furosemide in Neonates: A Review

Necrosis grasa del recién nacido

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