Subcutaneous Fat Necrosis of the Newborn: A Case Report of a Term Infant Presenting with Malaise and Fever at Age of 9 Weeks

Ayuk, Adaeze C; Jude, Anikene Chukwuemeka

doi:10.1155/2015/638962

Cited by 6 publications

(10 citation statements)

References 16 publications

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“…Nekrosis lemak subkutan pada bayi baru lahir (subcutaneous fat necrosis of the newborn, adiponecrosis subcutanea) merupakan panikulitis pada bayi baru lahir cukup bulan atau lebih bulan yang ditandai dengan nodus atau plak subkutan di area kulit yang terlokalisasi. 1 Kondisi ini jarang terjadi dan berkaitan dengan masalah yang timbul saat kehamilan atau penyulit sebelum, saat, atau setelah kelahiran. 2 Pada studi retrospektif selama 20 tahun di rumah sakit rujukan tersier di Toronto Kanada, didapatkan 30 bayi yang didiagnosis nekrosis lemak subkutan, dengan perbandingan laki-laki dan perempuan 1,14:1.…”

Section: Pendahuluanunclassified

“…Tidak ada perbedaan insidens pada bayi laki-laki maupun perempuan. 1 Kondisi ini terjadi pada minggu awal kehidupan dan dapat sembuh secara spontan (self-limited disease). Mekanisme NLS pada BBL terjadi karena hipoksia atau hipotermi yang memicu defek biokimiawi pada komposisi atau metabolisme lemak neonatus sehingga terjadi inflamasi, nekrosis, dan kristalisasi lemak neonatus.…”

Section: Diskusiunclassified

“…Pemantauan sebaiknya dilakukan dengan interval dua minggu sekali hingga pasien berusia enam bulan. 1,13 Trombositopenia terjadi karena pemecahan trombosit dalam jaringan yang mengalami inflamasi dan akan berangsur membaik setelah proses inflamasi mereda. Selain itu, trombositopeni juga dapat terjadi sebagai akibat hipoksemia, sedangkan hipertrigliseridemia terjadi karena mobilisasi asam lemak jaringan adiposa yang mengalami inflamasi ke darah perifer.…”

Section: Diskusiunclassified

“…Hiperkalsemia terjadi akibat peningkatan produksi 1,25-dihidroksivitamin D 3 (kalsitriol) yang diaktifkan oleh makrofag lesi granulomatosa nekrosis lemak subkutan sehingga meningkatkan penyerapan kalsium dari usus dan mobilisasi kalsium dari tulang. 1,8 Selain dapat menyebabkan kalsifikasi pada kulit, falx cerebri, ginjal, mukosa gaster dan miokardium, hiperkalsemia pada neonatus juga dapat menyebabkan kejang, henti jantung, serta gagal ginjal. Kondisi ini secara klinis ditandai dengan letargi, iritabilitas, hipotonia, muntah, poliuri, polidipsi, dehidrasi, konstipasi, dan gagal tumbuh.…”

Section: Diskusiunclassified

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Nekrosis Lemak Subkutan Dengan Kutis Marmorata Fisiologis Pada Bayi Baru Lahir

Rayinda

Galvani

Irianiwati

et al. 2019

MDVI

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ABSTRAKNekrosis lemak subkutan pada bayi lelaki baru lahir merupakan panikulitis yang jarang terjadi. Kelainan ini dijumpai pada bayi baru lahir (BBL) cukup bulan atau lebih bulan, ditandai dengan nodus atau plak subkutan di area kulit yang terbatas/terlokalisasi. Kutis marmorata fisiologis ditandai oleh "patch" eritematosa yang tersusun retikuler dan membentuk gambaran seperti marmer. Lesi kulit ini merupakan respons vaskular tubuh bayi terhadap suhu dingin. Kondisi ini hilang timbul sesuai perubahan suhu lingkungan. Pada makalah ini dilaporkan satu kasus nekrosis lemak subkutan pada BBL disertai dengan kutis marmorata fisiologis. Diagnosis ditegakkan berdasarkan pemeriksaan klinis dan histopatologis. Faktor risiko yang ditemukan berupa riwayat asfiksia saat lahir dan riwayat preeklamsi berat pada ibu selama hamil. Tujuan laporan kasus ini adalah untuk meningkatkan kewaspadaan klinisi terhadap kelainan kulit yang mungkin dijumpai pada bayi baru lahir dan diharapkan dapat meningkatkan kemampuan dalam mendiagnosis dan mengelola kasus nekrosis lemak subkutan. Kata kunci: Subcutaneous fat necrosis of the newborn, nekrosis lemak subkutan, kutismarmorata fisiologisABSTRACT Subcutaneous fat necrosis of the newborn (SFN) is a rare form of panniculitis developed in the fullterm or post-term newborn. It is characterized by subcutaneous noduses or indurated plaques on a localized skin. Physiological cutis marmorata is characterized by erythematous patch arranged in reticular form, resembling marble appearance, which is emanated as physiological vascular responsse to the temperature of the surrounding environment. We reported a case of SFN presenting with physiological cutaneous marmorata in a 22-day-old neonates who had history of neonatal asphyxia and related to maternal preeclampsia. By comprehending the clinical characteristic and management of this condition, clinicians should be aware to this condition that can be developed following various risk factors attributed to SFN and the complications that probably occurred.

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Section: Pendahuluanunclassified

Section: Diskusiunclassified

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Nekrosis Lemak Subkutan Dengan Kutis Marmorata Fisiologis Pada Bayi Baru Lahir

Rayinda

Galvani

Irianiwati

et al. 2019

MDVI

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“…The occurrence of SCFN is generally linked with neonatal asphyxia. 1 , 2 Despite being a benign condition, SCFN is known to be associated with disorders such as hypoglycemia, thrombocytopenia, hypercalcemia and hypertriglyceridemia. It is a temporary, auto-resolving condition, still, the early diagnosis of SCFN is necessary for proper management and treatment.…”

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Neonatal subcutaneous fat necrosis with hypercalcemia treatment using calcitonin

Al-Sofyani

2018

SMJ

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Subcutaneous fat necrosis of newborn is a form of noninfectious panniculitis. It is an uncommon condition and mostly occurs in full-term infants within first weeks of life that have had a significant condition such as hypoxic-ischemic encephalopathy at the time of birth. Subcutaneous fat necrosis of newborn is usually a self-limiting condition but may be associated with hypercalcemia, which may lead to life threatening levels. Hypercalcemia is a significant reason of subcutaneous fat necrosis and needs an intervention involving hyperhydration, calcitonin, diuretics, steroids and sometimes bisphosphonate in resistant cases. Here, we have reported the case of a term infant who developed extensive subcutaneous fat necrosis in the first week of life after significant perinatal hypoxic injury. Her condition was complicated by hypercalcemia resistant to prolonged medical treatment with hyperhydration, diuretic and steroid but eventually the infant responded to high doses of calcitonin.

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Subcutaneous fat necrosis in an infant with hypoxic ischaemic encephalopathy stage 3: an uncommon association

et al. 2021

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Subcutaneous fat necrosis (SCFN) is inflammation and necrosis of adipose tissue associated with hypoxia and hypothermia. It leads to various metabolic abnormalities, of which the most dreaded is hypercalcaemia. We report a case of a 7-week-old boy with history of birth asphyxia (hypoxic ischaemic encephalopathy stage 3) who presented to us with features suggestive of hypercalcaemia with bilateral nephrocalcinosis. On examination, there were multiple subcutaneous nodules on both arms. Evaluation revealed suppressed parathyroid activity along with low levels of 25(OH)vitamin D3 and elevated 1,25-dihydroxyvitamin D3. Skin biopsy confirmed the diagnosis of SCFN. He was managed with intravenous fluids, single dose of intravenous furosemide and oral prednisolone. Hypercalcaemia responded within 14 days of admission, prednisolone was tapered and stopped in a month. SCFN, in our case, can be attributed to the underlying perinatal asphyxia along with use of therapeutic hypothermia. Through this case, we wish to sensitise practicing neonatologists for the need of screening and early identification of these abnormalities, which if missed can be fatal.

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Subcutaneous Fat Necrosis of the Newborn: A Case Report of a Term Infant Presenting with Malaise and Fever at Age of 9 Weeks

Cited by 6 publications

References 16 publications

Nekrosis Lemak Subkutan Dengan Kutis Marmorata Fisiologis Pada Bayi Baru Lahir

Nekrosis Lemak Subkutan Dengan Kutis Marmorata Fisiologis Pada Bayi Baru Lahir

Neonatal subcutaneous fat necrosis with hypercalcemia treatment using calcitonin

Subcutaneous fat necrosis in an infant with hypoxic ischaemic encephalopathy stage 3: an uncommon association

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