title: Oral clodronate therapy for hypercalcemia related to extensive subcutaneous fat necrosis in a newborn.
abstract: Hypercalcemia is occasionally found in newborns with subcutaneous fat necrosis and carries potential life-threatening risk. Bisphosphonates have been recently introduced in the treatment of subcutaneous fat necrosis in newborns. We report a case of extensive subcutaneous fat necrosis in a female infant complicated with intractable hypercalcemia. Standard treatment for hypercalcemia was given, including saline hydration, a low calcium diet, furosemide, and glucocorticoid, but without response. Serum 1,25-dihydroxyvitamin D level was elevated at 126 pg/mL, 25-hydroxyvitamin D level was normal, and intact parathyroid hormone was suppressed at < 1 pg/mL. Oral clodronate disodium, a second-generation bisphosphonate, was administered, and resulted in the normalization of serum calcium, urine N-telopeptide, urine calcium/creatinine ratio, and serum intact parathyroid hormone level. This case suggests that oral clodronate may be an effective treatment for subcutaneous fat necrosis with hypercalcemia in newborns.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Shuo-Hsun
authors.initials: SH
authors.lastname: Hung
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Tsai
authors.forename: Po-Nien
authors.initials: PN
authors.lastname: Tsao
authors.forename: Hung-Chieh
authors.initials: HC
authors.lastname: Chou
authors.forename: Wu-Shiun
authors.initials: WS
authors.lastname: Hsieh
mesh_terms: D000284:Administration, Oral; D000963:Antimetabolites / Q000627:therapeutic use*; D004002:Clodronic Acid / Q000627:therapeutic use*; D005218:Fat Necrosis / Q000150:complications / Q000151:congenital*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy* / Q000209:etiology; D007231:Infant, Newborn
chemical_list: D000963:Antimetabolites; D004002:Clodronic Acid