%0 Journal Article
%T Hipercalcemia mantenida secundaria a necrosis grasa subcut芍nea Maintained hypercalcemia secondary to subcutaneous fat necrosis
%A R. Pardo
%A M. Mor芍n
%A C.C. 芍lvarez
%A G. Sol赤s
%J Bolet赤n de Pediatr赤a
%D 2010
%I Sociedad de Pediatr赤a de Asturias, Cantabria y Castilla y Le車n
%X Introducci車n: La necrosis grasa subcut芍nea del reci谷n nacido es una paniculitis transitoria aguda de presentaci車n infrecuente en la infancia, con lesiones cut芍neas caracter赤sticas y de evoluci車n generalmente benigna. De las diversas complicaciones asociadas, la hipercalcemia es la m芍s frecuente y la m芍s severa. Caso cl赤nico: Neonato de sexo femenino nacida de gestaci車n a t谷rmino, que ingresa en una Unidad de Neonatolog赤a por s赤ndrome de aspiraci車n meconial. En las primeras horas de vida presenta acidosis mixta severa, hipoglucemia, trombopenia y recibe tratamiento con ventilaci車n mec芍nica y antibioterapia. Presenta n車dulos viol芍ceos en la regi車n gl迆tea y la espalda a los 4 d赤as de vida, con diagn車stico final de necrosis grasa subcut芍nea tras estudio histopatol車gico. Las lesiones cut芍neas han evolucionado favorablemente. Durante los primeros meses de vida present車 hipercalcemia moderada que curs車 cl赤nicamente con episodios de irritabilidad, rechazo de tomas y estancamiento ponderal. Recibi車 tratamiento con hidrataci車n intravenosa, exclusi車n de vitamina D y corticoides, con normalizaci車n de los niveles de calcio s谷rico a los 12 meses de edad sin evidencia de calcificaciones tisulares. Conclusiones: Es imprescindible un seguimiento precoz y prolongado de los pacientes con necrosis grasa subcut芍nea, sobre todo para la detecci車n temprana de alteraciones metab車licas potencialmente graves como la hipercalcemia. Introduction: Subcutaneous fat necrosis of the newborn is an uncommon panniculitis, with carachteristical skin lesions; prognosis is considered good. Several complications have been reported, being hypercalcaemia the most frequent and severe. Case: Female newborn had a history of meconium aspiration syndrome, acidosis, hypoglicemia and thrombocytopenia, thus she was treated with mechanical ventilation and antibiotics in a Neonatal Unit. Violaceus subcutaneous nodules in back and buttocks appeared at day 4. Diagnosis of subcutaneous fat necrosis was made by dermatologists based on clinical and histological findings obtained by skin biopsy; cutaneous lesions disappeared after several months. The patient had moderate symptomatic hypercalcaemia, presenting irritability, feeding problems and failure to thrive, and she received treatment with intravenous fluids and short-term oral steroids therapy. Serum calcium was normal by 12 months-old with no evidence of tissue calcifications. Conclusions: Patients with subcutaneous fat necrosis must be under surveillance on first months of life in order to early detection of metabolic complications such hypercalcaemia.
%U http://sccalp.org/documents/0000/1523/BolPediatr2010_50_028-032.pdf