Oral clodronate therapy for hypercalcemia related to extensive subcutaneous fat necrosis in a newborn

J Formos Med Assoc. 2003 Nov;102(11):801-4.

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.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Antimetabolites / therapeutic use*
  • Clodronic Acid / therapeutic use*
  • Fat Necrosis / complications
  • Fat Necrosis / congenital*
  • Female
  • Humans
  • Hypercalcemia / drug therapy*
  • Hypercalcemia / etiology
  • Infant, Newborn

Substances

  • Antimetabolites
  • Clodronic Acid