We present a case that illustrates the fluctuations in calcium levels to be expected while managing an infant with maternal gestational diabetes mellitus who also develops subcutaneous fat necrosis (SCFN). There is initial hypocalcaemia due to functional hypoparathyroidism, requiring judicious calcium replacement. But with increased extrarenal production of 1,25-dihydroxyvitamin D due to granulomatous inflammation of subcutaneous adipose tissue, hypercalcaemia ensues. With a self-limiting course, SCFN of the newborn has an excellent prognosis and resolves spontaneously. However, aberrations in serum calcium levels can manifest in life-threatening complications and must hence be closely monitored.
- calcium and bone
- neonatal health
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Patient consent for publication Next of kin consent obtained.
Contributors WMS-W and myself (DC) were involved in the literature review, case summary, drafting of the manuscript and compiling of clinical information. MJAK was involved in the care of the patient, from the dermatological aspect. He was involved in the diagnosis and subsequent management of the patient. He proofread our manuscript and ensured that the dermatological aspect had been written succinctly and accurately. FKPY was involved in the care of the patient, from the endocrine aspect. He was involved in the management and follow-up of the calcium fluctuations. He also proofread our manuscript and ensured that the endocrinological aspect had been written up accurately.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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