Table 1.
Clinical Characteristics, Treatment, and Complications of Patients with Severe Hypercalcemia due to Subcutaneous Fat Necrosis
| Patient | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Sex | Male | Male | Male | Female | Male | Male | Female |
| Age at presentation (days) | 38 | 32 | 16 | 35 | 21 | 20 | 28 |
| Peak serum Ca (mmol/L) | 4.4 | 5.1 | 3.5 | 4.1 | 3.8 | 3.3 | 4.8 |
| PTH (pmol/L) | <0.3 | <0.1 | <0.1 | <0.3 | <0.3 | N/A | 0.3 |
| 25(OH)D (nmol/L) | 8.7 | 46.7 | 54.9 | 204.7 | 49.9 | N/A | 54.9 |
| 1,25(OH)2D (pmol/L) | 185 | N/A | N/A | 114 | 320 | 320 | 354 |
| Peak urine Ca/Cr (mmol/mmol) | 2.5 | 15.7 | 9.5 | 9.8 | 7.0 | 8.7 | 13.4 |
| Treatments received1 | IV,F,GC, DCR | IV,F,GC,C, DCR,CIT | IV,F,GC | IV,F,GC | IV,F,GC,PM, DCR,CIT | IV,F,DCR | IV,F,GC, DCR,CIT |
| Time to normocalcemia (days) | 2 | 5 | 18 | 5 | 14 | 42 | 9 |
| Fever | Yes | Yes | No | No | Yes | Yes | No |
| Result of sepsis evaluation | Negative | Bacteremia | N/A | N/A | UTI, RSV | Negative | N/A |
| Eosinophils (cells/uL) | 460 | 930 | 2870 | 900 | 520 | 570 | 910 |
| Nephrocalcinosis (months of follow up) | Persistent (10) | Persistent (20) | Not Assessed | Persistent (8) | Persistent (48) | No | Persistent (36) |
General abbreviations: Ca calcium; Cr creatinine; PTH parathyroid hormone; 25(OH)D 25-hydroxyvitamin D; 1,25(OH)2D 1,25-dihydroxyvitamin D; UTI urinary tract infection
Reference ranges: Ca 2.0–2.6 mmol/L; PTH 1.1–6.9 pmol/L; 25(OH)D 75–250 nmol/L; 1,25(OH)2D 39–195 pmol/L; urine Ca/Cr < 1.5 mmol/mmol; eosinophils 0–500 cells/uL
1
Treatments abbreviations: IV intravenous hydration; F furosemide; GC glucocorticoid; DCR dietary calcium restriction; C calcitonin; PM pamidronate; CIT citrate