Subcutaneous fat necrosis and persistent hypercalcaemia in a newborn treated with therapeutic neonatal hypothermia. A case report

• Published in: Archivos argentinos de pediatría Vol. 114; no. 1; pp. e13 - e16
• Main Authors: Martínez de Zabarte Fernández, José M, Laliena Aznar, Sara, Corella Aznar, Elena, Cuadrado Piqueras, Laura, Oliván del Cacho, María J, Pinillos Pisón, Raquel
• Format: Journal Article
• Language: Spanish
• Published: Argentina 01-02-2016
• Subjects: Exanthema - etiology; Fat Necrosis - etiology; Humans; Hypercalcemia - etiology; Hypothermia, Induced - adverse effects; Hypoxia-Ischemia, Brain - therapy; Infant, Newborn; Subcutaneous Fat - pathology; Therapeutic hypothermia; Newborn; Hypercalcaemia; Subcutaneous fat necrosis; Hypoxic-ischemic encephalopathy
• ISSN: 1668-3501
• DOI: 10.5546/aap.2016.e13

Therapeutic hypothermia is the current standard treatment in newborns with moderate to severe hypoxic-ischemic encephalopathy, changing the outcome of these children. It is considered a safe technique with almost no side effects. A possible adverse side event is subcutaneous fat necrosis, which is an acute self-limiting panniculitis that develops during the first weeks of life. We report a case of a newborn at term suffering hypoxic-ischemic encephalopathy with a generalized multiform erythematous rash and firm and indurated plaques over the back, buttocks and extremities on his 12th day of life after being treated with therapeutic hypothermia. Histopathological study after skin punchbiopsy confirmed the suspicion of subcutaneous fat necrosis. The infant developed asymptomatic moderate hypercalcaemia within the first month of life, which was treated with intravenous fluids and diuretics. Serum calcium levels decreased and normalized in 3 months, with progressive disappearance of skin lesions.