A Rare Case Report of a 8-weeks-old Infant with Hypercalcaemia and Subcutaneous Fat Necrosis

Abstract

Subcutaneous Fat Necrosis (SCFN) is an uncommon transient panniculitis more commonly seen in first week of newborn life. Hypercalcaemia is tell-tale of this disorder, resulting in consequences like metabolic derangements, polyuria, seizures, vomiting, nephrocalcinosis and cardiovascular disturbances contributing to morbidity and mortality of SCFN. This is a case report of an eight-week-old male infant who presented with hypercalcaemia and multiple nodules all over the body. Histopathology is the gold standard method which helps in diagnosis and evaluation of a patient with SCFN. In this case, histopathological report revealed focal areas of fat necrosis in the fat lobules along with lobular panniculitis with infiltration of lymphocytes, histocytes, fibroblasts and multinucleated giant cells. Its granules were suggestive of SCFN. The diagnosis of SCFN was confirmed by skin biopsy and additionally supported by hypercalcaemia. This study highlights the importance of performing detailed skin examination for the evaluation of patients until the resolution of hypercalcaemia and skin lesions. In this case, hypercalcaemia resolved by the end of 12th week of life. Though, it is a benign and self-limiting condition, educating and creating awareness among the parents is of utmost importance and to prevent renal and cardiac complications associated with hypercalcaemia. Rehydration therapy, calcium and Vitamin D restricted diet are the modes of treatment for treating this condition.

Keywords

• hypertriglyceridemia
• lobular panniculitis
• neonatal sepsis
• rehydration
• thrombocytopenia