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Vitamin D and Risk for Vitamin A Intoxication in an 18-Month-Old Boy

Valentina Talarico1, Massimo Barreca1, Rossella Galiano2

  • 1Department of Pediatrics, "Pugliese-Ciaccio" Hospital, 88100 Catanzaro, Italy.

Case Reports in Pediatrics
|August 2, 2016
PubMed

Insights

Over-treating vitamin D deficiency rickets can lead to vitamin D intoxication. This case highlights the importance of checking 25-hydroxyvitamin D levels before and during treatment to prevent toxicity.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Clinical Nutrition

Background:

  • Vitamin D deficiency rickets is common in infants.
  • Multivitamin preparations are widely used for prevention and treatment.
  • Inappropriate dosing can lead to toxicity.

Purpose of the Study:

  • To report a case of vitamin D intoxication in an infant.
  • To emphasize the importance of monitoring 25-hydroxyvitamin D levels.
  • To discuss the potential for over-treatment in rickets management.

Main Methods:

  • Case report of an 18-month-old boy with symptoms of hypercalcemia.
  • Laboratory investigations including serum calcium, parathyroid hormone (PTH), and 25-hydroxyvitamin D (25-OHD).
  • Renal ultrasound for nephrocalcinosis assessment.
  • Treatment with intravenous hydration, furosemide, and prednisolone.

Main Results:

  • The patient presented with hypercalcemia, low PTH, and extremely high 25-OHD levels.
  • Renal ultrasound revealed nephrocalcinosis.
  • Treatment normalized serum calcium and progressively reduced 25-OHD levels.
  • No signs of vitamin A intoxication were observed.

Conclusions:

  • Diagnosis of vitamin D deficiency rickets without monitoring 25-OHD levels can lead to over-treatment.
  • Vitamin D intoxication is a potential risk associated with excessive supplementation.
  • Careful monitoring and appropriate dosing are crucial for safe and effective rickets management.

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