Case Reports in Pediatrics (Jan 2016)

Vitamin D and Risk for Vitamin A Intoxication in an 18-Month-Old Boy

  • Valentina Talarico,
  • Massimo Barreca,
  • Rossella Galiano,
  • Maria Concetta Galati,
  • Giuseppe Raiola

DOI
https://doi.org/10.1155/2016/1395718
Journal volume & issue
Vol. 2016

Abstract

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An 18-month-old boy presented with abdominal pain, vomiting, diarrhea, and poor appetite for 6 days. He had been given a multivitamin preparation once daily, containing 50.000 IU of vitamin D and 10.000 IU of vitamin A for a wide anterior fontanelle for about three months. He presented with hypercalcemia, low levels of parathyroid hormone (PTH), and very high serum 25-hydroxyvitamin D (25-OHD) levels. Renal ultrasound showed nephrocalcinosis. He did not have sign or symptom of vitamin A intoxication. Patient was successfully treated with intravenous hydration, furosemide, and prednisolone. With treatment, serum calcium returned rapidly to the normal range and serum 25-OHD levels were reduced progressively. In conclusion the diagnosis of vitamin D deficiency rickets without checking 25-OHD levels may cause redundant treatment that leads to vitamin D intoxication (VDI).