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Posterior Reversible Encephalopathy Syndrome Due to Vitamin D Toxicity
Mackenzie O'Brien1, Eunice Koh1, Gabrielle Russo Barsh1
1Stanford Children's Health, Palo Alto, California.
Insights
Excessive vitamin D supplementation can cause toxicity, leading to severe symptoms like posterior reversible encephalopathy syndrome (PRES). This case highlights the critical need for safe vitamin D use in children.
Area of Science:
- Pediatric Medicine
- Endocrinology
- Toxicology
Background:
- Excessive exogenous vitamin D supplementation, while rare, can lead to toxicity with symptoms primarily stemming from hypercalcemia.
- Hypervitaminosis D can manifest in severe, life-threatening complications, necessitating awareness among healthcare providers.
Abstract:
Although toxicity from excessive exogenous vitamin D supplementation is rare, a range of symptoms can occur, most of which result from hypercalcemia. We report a novel case of posterior reversible encephalopathy syndrome (PRES) in a young child who required intensive care after presenting with hypercalcemia, hypertensive emergency, acute kidney injury, and hypercarbic respiratory failure, which ultimately were attributed to vitamin D toxicity (VDT). We report a young child who developed PRES in association with VDT. Our report informs pediatric outpatient, hospitalist, and intensivist providers about rare but life-threatening complications from hypervitaminosis D, adds VDT to the differential diagnosis for children with similar presentations, and highlights the importance of vitamin supplementation safety guidance for families.
