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广泛皮下脂肪坏死并发新生儿高钙血症。

Extensive subcutaneous fat necrosis complicated by neonatal hypercalcaemia.

机构信息

King AbdulAziz University Hospital, Department of Paediatrics.

King AbdulAziz University.

出版信息

Acta Biomed. 2021 Apr 30;92(S1):e2021081. doi: 10.23750/abm.v92iS1.8469.

DOI:10.23750/abm.v92iS1.8469
PMID:33944856
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8142782/
Abstract

subcutaneous fat necrosis is a benign and often self-limiting inflammatory disorder experienced by newborns who were exposed to perinatal stress in the form of asphyxia, hypothermia, cord prolapse, and/or sepsis. lesions are usually benign and self-limiting, with complete resolution anticipated within a few weeks up to 6 months. they can be accompanied by multiple complications. of which the most significant and of life-threatening potential is neonatal hypocalcaemia. if not timely anticipated and adequately treated, the patient might deteriorate due to dehydration and acute renal failure. symptoms of neonatal hypercalcaemia can be variable in this age group, transcending from a nonspecific presentation of irritability, poor feeding, vomiting and constipation to the well-recognised polyuria, polydipsia, and dehydration. therapeutic options are provided through initial hyperrehydration and calcium wasting diuretics, switching feeds to a low calcium and vitamin D formula milk, institution of systemic steriods and if necessary, inititating bisphosphonate therapy in hypercalcaemia that is severe, recalcitrant to the previously mentioned treatment modalities, and/or when a rapid decrease in serum calcium levels is desired. in this report we describe a case of a 10 month old female infant with moderate neonatal hypercalcaemia as a complication of extensive SCFN manifestating by the age of 10 days and persisting into a prolonged clinical course of up to 9 months until most of the lesions were resolved.

摘要

皮下脂肪坏死是一种良性且常为自限性炎症性疾病,常发生于经历围产期应激(如窒息、低体温、脐带脱垂和/或败血症)的新生儿。病变通常为良性且自限性,预计在数周到 6 个月内完全消退。它们可能伴有多种并发症,其中最严重且有生命威胁的是新生儿低钙血症。如果不能及时发现和充分治疗,患者可能会因脱水和急性肾衰竭而病情恶化。在这个年龄段,新生儿高钙血症的症状可能多种多样,从烦躁不安、喂养不良、呕吐和便秘等非特异性表现,到多尿、多饮和脱水等众所周知的表现。治疗选择包括初始高渗水化和钙流失利尿剂、更换低钙和维生素 D 配方奶、全身类固醇治疗,如果需要,在高钙血症严重、对上述治疗方法无反应且/或需要快速降低血清钙水平时,开始使用双膦酸盐治疗。在本报告中,我们描述了一例 10 个月大的女婴,因广泛皮下脂肪坏死导致中重度新生儿高钙血症,在 10 天大时出现,持续长达 9 个月的临床过程,直到大部分病变消退。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70f0/8142782/0a74ef676824/ACTA-92-81-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70f0/8142782/0a74ef676824/ACTA-92-81-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70f0/8142782/0a74ef676824/ACTA-92-81-g001.jpg

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1
Extensive subcutaneous fat necrosis complicated by neonatal hypercalcaemia.广泛皮下脂肪坏死并发新生儿高钙血症。
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本文引用的文献

1
Subcutaneous Fat Necrosis of the Newborn: A 20-Year Retrospective Study.新生儿皮下脂肪坏死:一项20年的回顾性研究。
Pediatr Dermatol. 2016 Nov;33(6):e353-e355. doi: 10.1111/pde.12973. Epub 2016 Aug 30.
2
Subcutaneous Fat Necrosis of the Neonate with a Delayed Second Eruption.新生儿皮下脂肪坏死伴延迟性二次发疹
Pediatr Dermatol. 2016 Mar-Apr;33(2):e134-6. doi: 10.1111/pde.12764. Epub 2016 Jan 29.
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Subcutaneous fat necrosis of the newborn.新生儿皮下脂肪坏死
Clin Case Rep. 2015 Nov 5;3(12):1017-20. doi: 10.1002/ccr3.423. eCollection 2015 Dec.
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Neonatal hypercalcemia secondary to subcutaneous fat necrosis successfully treated with pamidronate: a case series and literature review.皮下脂肪坏死继发新生儿高钙血症经帕米膦酸成功治疗:病例系列及文献综述
AJP Rep. 2014 Nov;4(2):e93-6. doi: 10.1055/s-0034-1395987. Epub 2014 Nov 19.
5
A neonate with subcutaneous fat necrosis after passive cooling: does polycythemia have an effect?被动冷却后发生皮下脂肪坏死的新生儿:红细胞增多症有影响吗?
Case Rep Pediatr. 2013;2013:254089. doi: 10.1155/2013/254089. Epub 2013 Jul 9.
6
Tender skin nodules in a newborn.新生儿身上的压痛性皮肤结节。
Indian J Dermatol. 2013 Jul;58(4):328. doi: 10.4103/0019-5154.113983.
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Follow-up during early infancy of newborns diagnosed with subcutaneous fat necrosis.对诊断为皮下脂肪坏死的新生儿在婴儿早期进行随访。
J Clin Res Pediatr Endocrinol. 2011;3(4):216-8. doi: 10.4274/jcrpe.355.
8
Subcutaneous fat necrosis of the newborn: hypercalcaemia with hepatic and atrial myocardial calcification.新生儿皮下脂肪坏死:伴有肝脏和心房心肌钙化的高钙血症。
Arch Dis Child Fetal Neonatal Ed. 2003 Jul;88(4):F343-5. doi: 10.1136/fn.88.4.f343.
9
Complications of subcutaneous fat necrosis of the newborn: a case report and review of the literature.新生儿皮下脂肪坏死的并发症:一例病例报告及文献综述
Pediatr Dermatol. 2003 May-Jun;20(3):257-61. doi: 10.1046/j.1525-1470.2003.20315.x.
10
Etidronate therapy for hypercalcemia in subcutaneous fat necrosis of the newborn.依替膦酸治疗新生儿皮下脂肪坏死中的高钙血症。
J Pediatr. 1999 Mar;134(3):349-51. doi: 10.1016/s0022-3476(99)70462-2.