6533b82afe1ef96bd128b874
RESEARCH PRODUCT
Use of Zoledronic Acid in a Neonate with Subcutaneous Fat Necrosis Complicated with Severe, Refractory Hypercalcemia.
Salvino Marcello VitalitiMaria Paola ReGiuliana VitalitiMaria Angela MilitelloFrancesca FinazzoPaolo Manzonisubject
medicine.medical_specialtyNecrosisTerm BirthDrug ResistanceSubcutaneous FatAdipose tissuehypercalcemia; neonate; subcutaneous fat necrosis; zoledronic acid; Bone Density Conservation Agents; Calcium; Drug Resistance; Fat Necrosis; Female; Furosemide; Glucocorticoids; Humans; Hypercalcemia; Infant Newborn; Methylprednisolone; Sodium Potassium Chloride Symporter Inhibitors; Subcutaneous Fat; Term Birth; Zoledronic AcidGastroenterologyMethylprednisoloneZoledronic AcidRefractorySodium Potassium Chloride Symporter InhibitorsFurosemideInternal medicinesubcutaneous fat necrosismedicineHumansFat necrosisFat NecrosisGlucocorticoidsBone Density Conservation Agentsbusiness.industryStandard treatmentInfant NewbornObstetrics and GynecologyFurosemideInfantmedicine.diseaseNewbornZoledronic acidMethylprednisolonePediatrics Perinatology and Child HealthHypercalcemiaCalciumFemalemedicine.symptomneonatebusinessmedicine.drugdescription
Objective Subcutaneous fat necrosis (SCFN) is a rare condition that may occur in the neonatal period. SCFN is an inflammatory disorder of the adipose tissue, usually found in full-term healthy infants who have a history of intrauterine or perinatal distress. It is usually a self-limited condition; however, in some cases, it can get complicated, leading to severe hypercalcemia that may be life-threatening. Study Design We report and describe a classic presentation of SCFN that led to severe hypercalcemia refractory to standard treatment. The diagnosis of SCFN was made based on the finding of subcutaneous nodules and of hypercalcemia. The serum calcium level reached 16.6 mg/dL. Hypercalcemia was treated first with intravenous infusions of fluids and furosemide and then of methylprednisolone. This standard treatment was not effective; therefore, we administered a single low dose of zoledronic acid, which, in turn, was efficacious in ultimately managing the hypercalcemia. Conclusion Our case shows how a single low dose of zoledronic acid was safe and effective in managing severe hypercalcemia unresponsive to conventional treatment while minimizing the risk of hypocalcemic rebounds.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-06-25 | American journal of perinatology |