Hipercalcemia grave em lactente por hipervitaminose D iatrogênica: relato de caso

Abstract

INTRODUCTION: Vitamin D intoxication among nurslings (serum levels of 25-hydroxyvitamin D above 150 ng/mL) is a factor in the development of hypercalcemia, an uncommon condition in pediatrics. OBJECTIVE: Report a case of severe hypercalcemia caused by hypervitaminosis D in a nursling. CASE REPORT: 5-months-old masculine child, exclusively breastfed, referred to a specialist with suspected cows milk protein allergy because he failed to gain weight in the last month and presented with blood and mucus in stool. Beyond failure to thrive, the patient evolved with somnolence, apathy and hypotonia. Laboratorial tests revealed hypercalcemia (serum calcium of 17,40 mg/dL) and hypervitaminosis D (180 ng/mL). The hypothesis of vitamin D intoxication was raised and later confirmed by the laboratorial analysis of the supplement offered to the nursling, which revealed a vitamin D concentration 46 times greater than the originally prescribed by the pediatrician. CONCLUSION: Due to the currently high diagnostic suspicion of cows milk protein allergy in nurslings, other causes of these symptoms cant be neglected in the investigation when the elimination diet fails. In this nursling, the persistence of failure to thrive, apathy, anorexia and hypotonia during four months motivated the investigation that showed a severe hypercalcemia due to the usage of manipulated vitamin D.

Keywords

• hypercalcemia
• vitamin d
• case reports
• infant