Abstract
Therapeutic hypothermia (TH) is provided to newborns with moderate to severe hypoxic-ischemic encephalopathy (HIE) to improve survival and long-term neurodevelopmental outcomes. Although the benefits certainly outweigh the risks associated with therapeutic hypothermia, it is important to be mindful of potential rare side effects in the background of asphyxia-related injury to various body organs. One of those side effects includes subcutaneous fat necrosis (SCFN) that can occur in term newborns after perinatal hypoxia-ischemia or other stressing factors such as systemic hypothermia. It is usually a self-limited condition, however, in some cases, it can lead to severe hypercalcemia. We report three such cases of SCFN in newborns with HIE treated with TH. Due to potential long-term complications, such as metastatic calcifications, caregivers should be informed about this potential complication prior to discharge from hospital so that they can help diagnose or continue to monitor cases of severe hypercalcemia.
Highlights
Perinatal asphyxia can cause hypoxic injury to various body organs such as the brain, heart, liver, intestines, and skin
We report three cases of subcutaneous fat necrosis (SCFN) in infants admitted to our Bellevue Hospital regional perinatal center (RPC) with perinatal asphyxia
SCFN is a rare, but possibly serious, side effect seen in infants with hypoxic-ischemic encephalopathy (HIE) and treated with Therapeutic hypothermia (TH) because of its potential to lead to severe hypercalcemia
Summary
Perinatal asphyxia can cause hypoxic injury to various body organs such as the brain, heart, liver, intestines, and skin. It may be complicated by the presence of other side effects such as high serum calcium levels [7,8] Hypercalcemia in these infants may become symptomatic and require treatment in a few cases with hydration, loop diuretics, How to cite this article Verma S, Bailey S M, Mally P V, et al (July 30, 2018) Subcutaneous Fat Necrosis and Hypercalcemia After Therapeutic Hypothermia in Patients With Hypoxic-ischemic Encephalopathy: A Case Series. Since levels continued to increase despite hydration and diuretic therapy, the baby was started on hydrocortisone and given a dose of pamidronate This helped in decreasing calcium levels, which eventually came back to the normal range on DOL 35 (Figure 1). Serum calcium levels were normalized by DOL 39 (Figure 3)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
