Hypoparathyroidism and liver disease--evidence for a vitamin D hydroxylation defect. A case report

The case history of a 4 year old girl with primary hypoparathyroidism is reported. Treatment with oral 1 alpha-hydroxyvitamin D3 did not result in normal calcium and phosphate levels, whereas treatment with oral 1 alpha,25-dihydroxyvitamin D3 did. During the treatment period, the patient developed signs of severe liver disease and died in a picture of increased intracranial pressure. Post-mortem examination revealed a giant cell hepatitis and severe cirrhosis. The clinical course is consistent with a liver vitamin D3 hydroxylation defect.