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

Abstract EN

An 18-month-old boy presented with abdominal pain, vomiting, diarrhea, and poor appetite for 6 days.

He had been given a multivitamin preparation once daily, containing 50.000 IU of vitamin D and 10.000 IU of vitamin A for a wide anterior fontanelle for about three months.

He presented with hypercalcemia, low levels of parathyroid hormone (PTH), and very high serum 25-hydroxyvitamin D (25-OHD) levels.

Renal ultrasound showed nephrocalcinosis.

He did not have sign or symptom of vitamin A intoxication.

Patient was successfully treated with intravenous hydration, furosemide, and prednisolone.

With treatment, serum calcium returned rapidly to the normal range and serum 25-OHD levels were reduced progressively.

In conclusion the diagnosis of vitamin D deficiency rickets without checking 25-OHD levels may cause redundant treatment that leads to vitamin D intoxication (VDI).