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Iatrogenic calcinosis cutis in a preterm infant

Open AccessPublished:September 09, 2022DOI:https://doi.org/10.1016/j.pedneo.2022.05.013
      Extravasation phlebitis over the right forearm of a preterm newborn persisted beyond 3 weeks of limb care. The initial swelling evolved into a firm, non-tender, non-erythematous induration. The newborn was born as a singleton preterm birth at 32 weeks of gestation with a birth weight of 2.1 Kg (81 percentile) due to antepartum hemorrhage in a primigravida mother. The chart review suggested intravenous calcium gluconate infusion at 80 mg/kg per day for 2 days because of low ionized calcium (0.70 mmol/L) and seizures on day 2 of life. The growing preterm newborn was supplemented with oral calcium phosphate and vitamin D in appropriate doses.
      • Harding J.E.
      • Wilson J.
      • Brown J.
      Calcium and phosphorus supplementation of human milk for preterm infants.
      A right forearm skiagram taken at 3 weeks of extravasation suggested focal subcutaneous calcification (Fig. 1A and B). An anecdotal diagnosis of calcium gluconate deposition is most evident.
      • Sonohata M.
      • Akiyama T.
      • Fujita I.
      • Asami A.
      • Mawatari M.
      • Hotokebuchi T.
      Neonate with calcinosis cutis following extravasation of calcium gluconate.
      This iatrogenic variety of calcinosis cutis is diagnostic on a plain skiagram with the phlebitis injury over the forearm.
      • Sonohata M.
      • Akiyama T.
      • Fujita I.
      • Asami A.
      • Mawatari M.
      • Hotokebuchi T.
      Neonate with calcinosis cutis following extravasation of calcium gluconate.
      • Ching D.L.
      • Wong K.Y.
      • Milroy C.
      Iatrogenic calcinosis cutis following a neonatal extravasation injury.
      • Cherian E.V.
      • Shenoy K.V.
      • Daniel J.
      Iatrogenic calcinosis cutis in a neonate.
      Figure 1
      Figure 1Lateral (1A) and anteroposterior (1B) skiagram of the right forearm depicting linear bands, as well as scattered calcification underneath the skin along the subcutaneous planes, suggesting calcinosis cutis (red arrow).
      Conditions, such as idiopathic calcinosis cutis and subcutaneous fat necrosis with an aberrant calcium-phosphate metabolism, were excluded because lab reports were unremarkable for complete blood counts, liver function test, total calcium, phosphate, alkaline phosphatase, and vitamin D levels. Inflammatory markers were reassuring. The newborn was thriving well on exclusive breast feeds, and a complete spontaneous clinical resolution was seen over the next 6 weeks.

      Declaration of competing interest

      The authors declare no conflict of interest.

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