Oral alendronate therapy for severe vitamin D intoxication of the infant with nephrocalcinosis

Area of Science:

• Pediatric Endocrinology
• Clinical Pharmacology
• Nephrology

Background:

• Vitamin D intoxication is a recognized cause of hypercalcemia in children.
• Hypercalcemia management in infants often requires careful consideration of underlying causes and patient-specific factors.

Observation:

• A 7-month-old infant presented with hypercalcemia secondary to vitamin D intoxication.
• The infant also had concurrent nephrocalcinosis, complicating management.
• Initial treatments including hydration, diuretics, and corticosteroids were insufficient.

Findings:

• Oral alendronate was administered to the infant for hypercalcemia treatment.
• Serum calcium levels were successfully normalized following oral alendronate therapy.
• No adverse complications were observed during the treatment course.

Implications:

• Oral alendronate represents a safe and effective therapeutic option for pediatric hypercalcemia stemming from vitamin D intoxication.
• This approach is particularly valuable in cases resistant to conventional treatments like hydration, diuretics, or corticosteroids.
• The findings suggest alendronate's potential role in managing severe hypercalcemia with nephrocalcinosis in infants.