Subcutaneous Fat Necrosis with Thrombocytopenia in a Newborn Infant

Abstract

A case of subcutaneous fat necrosis (SCFN) in a newborn who had suffered from asphyxia secondary to meconium aspiration is described. During the third week of life, bluish-red subcutaneous nodules were noticed. A biopsy of the lesions showed subcutaneous necrosis with fat cells containing needle-like crystals with reactive inflammatory infiltrates. Peripheral transient thrombocytopenia was observed prior to the appearance of subcutaneous fat necrosis. The good prognosis is stressed.

Complications of Subcutaneous Fat Necrosis of the Newborn: A Case Report and Review of the Literature

“…However, several authors implicated gestational diabetes as a possible precipitating factor in the development of subcutaneous fat necrosis, and hypoglycemia was secondary to being an infant of a diabetic mother (6,12–14). Oswalt et al (4) and many other authors (10,11,15) reported hypoglycemia in their patients with subcutaneous fat necrosis born to nondiabetic mothers. Similarly Burden and Krafchik (16) reported 4 of their 11 patients with subcutaneous fat necrosis developed hypoglycemia in the first few weeks of life, and none of the 4 were born to a diabetic mother.…”

“…The cause of the thrombocytopenia is speculative. In a few cases where a bone marrow biopsy was performed, the normal bone marrow findings suggested a peripheral origin for the thrombocytopenia (11). Chen et al (1) proposed that it may reflect a local sequestration of the platelets within the subcutaneous tissue.…”

“…Thrombocytopenia usually appears before or at the same time as the onset of cutaneous lesions (1,4,9,10). The lowest reported platelet count was 20,000/mm 3 (11). No bleeding problems have been reported.…”

“…However, several authors implicated gestational diabetes as a possible precipitating factor in the development of subcutaneous fat necrosis, and hypoglycemia was secondary to being an infant of a diabetic mother (6,(12)(13)(14). Oswalt et al (4) and many other authors (10,11,15) necrosis developed hypoglycemia in the first few weeks of life, and none of the 4 were born to a diabetic mother. In our case, the infant's hypoglycemia may be the result of perinatal distress or maternal gestational diabetes or a complication of subcutaneous fat necrosis.…”

Subcutaneous fat necrosis of the infant

“…Corticosteroids, calcitonin, citrate and bisphosphonates may be required as second-line therapy in resistant cases (10,15). Hypertriglyceridemia and anemia may also occur, as well as thrombocytopenia and hypoglycemia (8,10,14).…”