一名皮下脂肪坏死患者出现高钙血症、高钾血症和室上性心动过速。

Hypercalcemia, hyperkalemia and supraventricular tachycardia in a patient with subcutaneous fat necrosis.

作者信息

Bahadur Kandy A, Johnson Stacey, Lentzner Benjamin, Gangat Mariam, Carlson Joann, Balachandar Sadana

机构信息

Rutgers Robert Wood Johnson Medical School, Department of Pediatrics, Division of General Pediatrics, 125 Paterson Street, Medical Education Building 308, New Brunswick, NJ 08903, USA.

Duke University Medical Center, Department of Pediatrics, Division of Pediatric Endocrinology, Durham, NC, USA.

出版信息

J Pediatr Endocrinol Metab. 2018 Mar 28;31(4):469-472. doi: 10.1515/jpem-2017-0365.

DOI:10.1515/jpem-2017-0365

PMID:29373320

Abstract

BACKGROUND

Subcutaneous fat necrosis (SCFN) is a rare, self-limiting condition that has been associated with several complications including hypercalcemia.

CASE PRESENTATION

We present the case of a 6-week-old male who presented to his pediatrician with a dime-sized erythematous nodule consistent with SCFN, who was also found to have supraventricular tachycardia (SVT). Laboratory findings revealed hypercalcemia and hyperkalemia. Extensive evaluation for the electrolyte disturbances revealed no other etiology. This case reinforces that SCFN should be considered in newborns with hypercalcemia of unknown etiology. Additionally, this case is the first to suggest a connection between SCFN and hyperkalemia. Electrolyte abnormalities can potentially contribute to arrhythmogenesis and may have triggered the arrhythmia in our patient.

CONCLUSIONS

Our case highlights the importance of remaining vigilant in the workup of atypical rashes of the infant, which should include early assessment of serum electrolytes.

摘要

背景

皮下脂肪坏死（SCFN）是一种罕见的自限性疾病，与包括高钙血症在内的多种并发症相关。

病例报告

我们报告一例6周龄男性患儿，因出现与皮下脂肪坏死相符的一角硬币大小的红斑结节就诊于儿科医生，该患儿还被发现患有室上性心动过速（SVT）。实验室检查发现高钙血症和高钾血症。对电解质紊乱进行的广泛评估未发现其他病因。该病例强调，对于病因不明的新生儿高钙血症应考虑皮下脂肪坏死。此外，该病例首次提示皮下脂肪坏死与高钾血症之间存在关联。电解质异常可能会促发心律失常，并且可能是我们这位患者心律失常的触发因素。