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[Overdose or hypersensitivity to vitamin D?].

F Hmami1, A Oulmaati1, A Amarti2

  • 1Service de néonatologie et réanimation néonatale, CHU Hassan II, 30000 Fès, Maroc; Université Sidi Mohammed Ben Abdellah, faculté de médecine et de pharmacie, Fès, Maroc.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|August 18, 2014
PubMed
Summary
This summary is machine-generated.

Vitamin D intoxication is rare but serious in infants, causing severe hypercalcemia. Nine cases highlight the risks of excessive vitamin D (Sterogyl®) supplementation, emphasizing the need for adherence to recommended dosages to prevent toxicity.

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Area of Science:

  • Pediatrics
  • Endocrinology
  • Toxicology

Background:

  • Vitamin D intoxication leading to severe hypercalcemia is uncommon in neonates and infants.
  • This study reviews vitamin D requirements and toxicity mechanisms, including hypersensitivity.

Observation:

  • Nine infants (25-105 days old) presented with severe dehydration, weight loss, vomiting, and fever.
  • Laboratory findings included significant hypercalcemia (113-235 mg/L), hypercalciuria, and toxic vitamin D levels (344-749 nmol/L).
  • Seven patients showed renal nephrocalcinosis on abdominal ultrasound; no CYP24A1 gene mutations were found.

Findings:

  • Infants receiving 600,000 units of vitamin D (Sterogyl®) developed severe hypercalcemia and dehydration.
  • Treatment involved intravenous rehydration, diuretics, and corticosteroids, with calcium levels normalizing in 4-50 days.
  • Long-term follow-up revealed persistent nephrocalcinosis in some cases.

Implications:

  • Genetic susceptibility and metabolic variations may influence individual vitamin D toxicity thresholds.
  • Strict adherence to recommended vitamin D dosages is crucial for preventing toxicity in infants.
  • This case series underscores the potential dangers of excessive vitamin D supplementation in early life.