Treatment with Neridronic Acid in a Newborn with Severe and Refractory Hypercalcemia Associated with Subcutaneous Fat Necrosis

Abstract

Neonatal subcutaneous fat necrosis (SCFN) is a transient, generally benign panniculitis that presents within several weeks of life and occurs mostly in term or post-term newborns who have a history of intrauterine or perinatal distress. It is usually a self-limited condition. Hypercalcemia is a rare but serious complication of SCFN and needs prolonged follow-up. The etiopathogenesis of both subcutaneous fat necrosis in newborn and the resultant hypercalcemia is poorly understood. We describe a classic presentation of SCFN that led to a severe hypercalcemia refractory to standard treatment. This case shows how a single dose of neridronic acid was safe and effective in managing severe hypercalcemia unresponsive to conventional therapy without hypocalcemic rebounds.