Vitamin D toxicity in a pediatric toxicological referral center; a cross-sectional study from Iran
Fariba Farnaghi1, Hossein Hassanian-Moghaddam2,3, Nasim Zamani2,3
1Departments of pediatrics, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, South Kargar St, Makhsos St,, Tehran, Iran.
Insights
Acute vitamin D toxicity in children appears benign, even with high ingested doses. Most children recovered without complications, suggesting a low risk of severe outcomes in this population.
Area of Science:
- Pediatrics
- Endocrinology
- Toxicology
Background:
- Vitamin D is crucial for health, with supplements commonly used to prevent deficiency.
- Widespread availability of vitamin D supplements increases the risk of accidental toxicity in children.
- Vitamin D deficiency is prevalent in Iran, potentially influencing toxicity outcomes.
Purpose of the Study:
- To investigate the clinical presentation and outcomes of acute vitamin D toxicity in pediatric patients.
- To evaluate the relationship between ingested vitamin D dose, serum levels, and clinical effects.
- To determine if acute vitamin D toxicity is a benign condition in Iranian children.
Main Methods:
- Retrospective review of pediatric patients under 12 years presenting with vitamin D supplement ingestion.
- Data collected included demographic information, dosage, clinical signs, symptoms, laboratory findings, and treatment.
- Analysis of 25-hydroxy vitamin D levels and correlation with clinical outcomes.
Main Results:
- Fifteen children (mean age 46.5 months, 80% female) were enrolled after unintentional vitamin D ingestion.
- Mean ingested dose was over 400,000 IU; 53.3% had elevated 25-hydroxy vitamin D levels (>100 ng/mL).
- One child experienced hypercalcemia, but all patients were asymptomatic and discharged without complications.
Conclusions:
- Acute vitamin D toxicity in this pediatric cohort was generally benign.
- The high prevalence of vitamin D deficiency in the region may contribute to the mild presentation of toxicity.
- Further research is needed to fully understand the long-term implications and management strategies.
Background:
Vitamin D is an essential element for body health with its supplements generally administered to prevent vitamin D deficiency. Since these supplements are available in domestic settings, vitamin D toxicity may happen in children.
Methods:
All children younger than 12 years who presented to the pediatric emergency department of Loghman Hakim Hospital, Tehran, Iran with history of ingestion of more than 1500 IU/day of vitamin D supplements were enrolled. Patients' demographic data, on-presentation signs and symptoms, laboratory findings, treatments given, and outcome were evaluated.
Result:
Fifteen patients presented during the study period. Their mean age was 46.53 ± 10.14 months and 12 (80%) were girls. All of them had unintentionally ingested vitamin D. Mean ingested dose was 406700.7 ± 227400.1 IU. In eight patients (53.3%), 25 hydroxy vitamin D level was more than 100 ng/mL. One patient experienced hypercalcemia while all of them were asymptomatic and discharged without complications. There was no significant difference between patients with and without high levels of 25 OH vitamin D regarding lab tests, toxicity course, and outcome.
Conclusions:
It seems that acute vitamin D toxicity is a benign condition in our pediatric population which may be due to high prevalence of vitamin D deficiency in Iran.
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