TY - JOUR T1 - Calcium management challenges in a macrosomic child with subcutaneous fat necrosis JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2018-227141 VL - 12 IS - 2 SP - e227141 AU - Daniel Chan AU - Wilsie Martillano Salas-Walinsundin AU - Fabian Kok Peng Yap AU - Mark Jean Aan Koh Y1 - 2019/02/01 UR - http://casereports.bmj.com/content/12/2/e227141.abstract N2 - 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. ER -