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[Hypercalcemia revealing iatrogenic hypervitaminosis A in a child with autistic troubles]
Insights
Hypervitaminosis A can cause infant hypercalcemia, often linked to specific diets. This case highlights the dangers of excessive vitamin A intake, particularly in children with autism.
Area of Science:
- Pediatrics
- Toxicology
- Nutrition
Background:
- Hypervitaminosis A is a rare condition resulting from excessive vitamin A intake.
- Infant hypercalcemia is a serious condition requiring prompt diagnosis and treatment.
Observation:
- A three-year-old boy presented with severe hypercalcemia and various symptoms including vomiting, headaches, fever, and skin abnormalities.
- The patient's condition was attributed to excessive vitamin A consumption (100,000-150,000 IU/day) as part of an "autistic diet".
Findings:
- Diagnosis was confirmed by elevated plasma vitamin A levels, increased vitamin A/RBP molar ratio, and the presence of retinyl palmitate.
- The patient's hypercalcemia was successfully treated with rehydration, bisphosphonates, and furosemide, normalizing calcium levels.
Implications:
- This case underscores the importance of considering vitamin A toxicity in unexplained hypercalcemia, especially in children.
- It also highlights the potential risks associated with restrictive or unconventional diets, such as those sometimes recommended for autistic children.
Unlabelled:
Hypervitaminosis A is an unusual cause of infant hypercalcemia. The way it occurs can be very surprising, as one can notice from the following case report.
Case Reports:
A three-year-old boy, presenting important behavioral disorders, was hospitalized because of a deterioration of his general state of health associated with vomiting, cephalgias, fever and cutaneous abnormalities. A 168 mg/L hypercalcemia was found. The only etiology is a deviant consumption of vitamin A within the framework of an "autistic diet": 100000 UI/d during three months, and then 150000 UI/d the three following months. Intoxication was confirmed by the increased vitamin A plasmatic level, and vitamin A/RBP molar ratio and by the presence of plasmatic retinyl palmitate. An emergency treatment by rehydration, biphosphonates and furosemide led to effective calcemia normalization.
Conclusion:
In the case of nonobvious causes of hypercalcemia, a thorough cross-examination must look for vitamin A intoxication. Our observation illustrates the danger of certain diets suggested for autistic children.
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