Neonatal Life-Threatening Nonoliguric Hyperkalemia Under Therapeutic Hypothermia

Author(s):  
Marco Piastra ◽  
Alessia Tempera ◽  
Maria Pia De Carolis ◽  
Lucilla Pezza ◽  
Orazio Genovese ◽  
...  
2019 ◽  
Vol 47 (9) ◽  
pp. 986-990 ◽  
Author(s):  
Mahdi Alsaleem ◽  
Lina Saadeh ◽  
Valerie Elberson ◽  
Vasantha H.S. Kumar

Abstract Objective To describe the clinical characteristics and risk factors in infants with subcutaneous fat necrosis (SFN) following therapeutic hypothermia for hypoxic-ischemic encephalopathy (HIE). Methods A case-control study was performed by a retrospective chart review of infants with moderate or severe HIE admitted to a level IV regional perinatal center and who underwent whole-body cooling. Results A total of 14 (8.1%) of 171 infants with moderate or severe HIE who underwent whole-body cooling developed SFN during hospitalization. There were more females [71% (10/14)] and large-for-gestational age (LGA) infants [28% (4/14)] in the SFN group vs. 36% females (57/157) and 8% LGA infants (13/157) in the group without SFN (P-values of 0.009 and 0.015, respectively). The mean lowest platelet count was lower 108 ± 55 109/L vs. 146 ± 62 109/L and the mean highest calcium level was higher 11.3 ± 2.5 vs. 10.6 ± 0.8 mg/dL in infants with SFN vs. infants without SFN, respectively (P-values of 0.0078 and 0.006, respectively). Distribution of skin lesions followed distinctive patterns representing the areas with direct contact with the cooling blanket. One infant developed severe, life-threatening hypercalcemia that required aggressive management, including diuretics, corticosteroids and bisphosphonates. Conclusion Although SFN is a rare complication of therapeutic hypothermia, it can be a life-threatening condition if complicated by severe hypercalcemia. Infants who undergo therapeutic hypothermia for HIE need regular skin examinations to evaluate for SFN. If SFN is identified, monitoring of serum calcium levels to prevent life-threatening hypercalcemia is recommended.


Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 374
Author(s):  
Katerina Chrysaidou ◽  
Georgios Sargiotis ◽  
Vasiliki Karava ◽  
Dimitrios Liasis ◽  
Victor Gourvas ◽  
...  

Subcutaneous fat necrosis is an uncommon benign panniculitis affecting more commonly full-term newborns. It has been associated with birth asphyxia and meconium aspiration, as well as therapeutic hypothermia. Although the prognosis is generally favorable, complications such as hypercalcemia, thrombocytopenia, hypoglycemia and hypertriglyceridemia may complicate its course. The most serious complication is hypercalcemia that may reach life threatening levels and can be associated with nephrocalcinosis. We thereby describe a case of subcutaneous fat necrosis after therapeutic hypothermia, which presented with late-onset refractory severe hypercalcemia and persistent nephrocalcinosis during the follow up of the patient. Due to the risk of the development of chronic kidney disease, we highlight the importance of careful monitoring of hypercalcemia and review the literature of subcutaneous fat necrosis related to nephrocalcinosis.


Author(s):  
L. VERBEKE ◽  
K. KAMOEN ◽  
L. AEYELS ◽  
J. VERAMME ◽  
N. DE CONO

Subcutaneous fat necrosis of the newborn with follow-up of the hypercalcemia A thirteen-day-old boy is diagnosed with subcutaneous fat necrosis of the newborn after the appearance of erythematous, subcutaneous plaques on the right shoulder. This rare, usually self-limiting cutaneous disease is mainly diagnosed in term and postterm infants. The diagnosis is confirmed by a skin biopsy. Various etiological hypotheses are suggested, although the exact pathogenesis needs to be elucidated. The disease might be associated with several maternal and foetal predisposing factors, including therapeutic hypothermia at birth as part of hypoxic ischemic encephalopathy. It is a benign inflammation of the subcutaneous adipocytes that can be accompanied by life-threatening complications, such as hypercalcemia and thrombocytopenia. The latter requires rigorous follow-up and, in some cases, also treatment. The skin damage should only be treated symptomatically with analgesia.


2007 ◽  
Vol 117 (2) ◽  
pp. e61-e63 ◽  
Author(s):  
Pedro Betrián Blasco ◽  
María Isabel Antúnez Jiménez ◽  
Luis Hipólito Falcón González ◽  
Pedro Suárez Cabrera

Author(s):  
Z. Hong Zhou ◽  
Jing He ◽  
Joanita Jakana ◽  
J. D. Tatman ◽  
Frazer J. Rixon ◽  
...  

Herpes simplex virus-1 (HSV-1) is a ubiquitous virus which is implicated in diseases ranging from self-curing cold sores to life-threatening infections. The 2500 Å diameter herpes virion is composed of a glycoprotein spike containing, lipid envelope, enclosing a protein layer (the tegument) in which is embedded the capsid (which contains the dsDNA genome). The B-, and A- and C-capsids, representing different morphogenetic stages in HSV-1 infected cells, are composed of 7, and 5 structural proteins respectively. The three capsid types are organized in similar T=16 icosahedral shells with 12 pentons, 150 hexons, and 320 connecting triplexes. Our previous 3D structure study at 26 Å revealed domain features of all these structural components and suggested probable locations for the outer shell proteins, VP5, VP26, VP19c and VP23. VP5 makes up most of both pentons and hexons. VP26 appeared to bind to the VP5 subunit in hexon but not to that in penton.


2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.


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