Subcutaneous fat necrosis (SCFN) is an uncommon cause of neonatal hypercalcemia. It is usually seen in neonates after a complicated delivery within the first month of life. While uncommon, hypercalcemia can be fatal. It is characterized by red-purple plaques in fatty points along with firm subcutaneous nodules. Rarely, SCFN may cause severe hypercalcemia with no visible skin lesion. In this rare case, we report severe infancy hypercalcemia without characteristic skin lesion on first physical examination, unresponsive to hydration, diuretic, prednisolone, and standard dose of pamidronate treatment. As timely diagnosis and treatment is so important, this complication should be kept in mind even in such clinical presentations.
Key words: Hypercalcemia, subcutaneous fat necrosis, pamidronate, infant
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