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Acute vitamin D intoxication in a child.
Fermin Barrueto1, Helena H Wang-Flores, Mary Ann Howland
1Division of Emergency Medicine, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA. fbarr001@umaryland.edu
Pediatrics
|September 6, 2005
Summary
A child experienced severe hypercalcemia and hypertension due to an accidental overdose of an imported vitamin D supplement. This case underscores the risks of unregulated medications and parental dosing errors.
Area of Science:
- Pediatrics
- Toxicology
- Endocrinology
Background:
- Vitamin D supplementation is crucial for pediatric health.
- Accidental overdoses can lead to severe toxicity.
- Imported or unregulated supplements may pose unique risks.
Observation:
- A 2-year-old boy presented with persistent colic and constipation.
- Initial examination was benign, but subsequent visits revealed severe hypercalcemia (14.4 mg/dL) and hypertension.
- The patient received an accidental overdose of an imported vitamin D supplement (Raquiferol), totaling 2,400,000 IU over 4 days.
Findings:
- Despite aggressive treatment, serum calcium levels remained elevated for 14 days.
- Vitamin D levels peaked at 470 ng/mL, correlating with clinical toxicity.
- The patient developed resistant hypercalcemia and persistent hypertension, without renal, cardiac, or neurologic complications.
Implications:
- Highlights the critical need for caution with imported and unregulated vitamin D supplements.
- Emphasizes the potential dangers of parental medication dosing errors in children.
- Underscores the importance of thorough patient history and medication reconciliation in emergency settings.