Hypercalcemia and Nephrocalcinosis in an Infant with Subcutaneous Fat Necrosis: A Rare but Potential Serious Clinical Condition

Background: Subcutaneous fat necrosis of the newborn (SCFN) is a panniculitis characterized by the presence of violaceous subcutaneous nodules and indurated plaques on the back, buttocks, proximal extremities, or cheeks. It is a self-limiting benign condition sometimes associated with hypercalcemia that can lead to serious complications such as seizures, failure to thrive and renal failure. It usually develops in full term neonates who experienced some perinatal stress. The literature shows that hypercalcemia is found in nearly 51% of infants, with 95% of the infants developing it within 60 days of onset of skin lesions.

Clinical Description: In this case, we describe a full-term female infant presented to us with failure to thrive at 2 months of age with a postnatal history of meconium aspiration syndrome. On further evaluation, child was found to have hypercalcemia, anemia and bilateral nephrocalcinosis.

Management & Outcome: The clinical findings and lab investigations were consistent with subcutaneous fat necrosis with hypercalcemia as its main complication. Child was successfully treated with oral corticosteroids.

Conclusion: Being a rare clinical condition, it is important to consider it as a differential diagnosis in infants with significant perinatal stress and hence this case report.