Pamidronate treatment of hypercalcemia caused by vitamin D toxicity.
We present a 16 month-old previously healthy boy with refractory hypercalcemia due to an overdose of an over-the-counter vitamin supplement. The patient presented to the emergency department with a few weeks' history of irritability, constipation and intermittent vomiting. His serum calcium was found to be 18 mg/dl. He was first treated with intravenous fluids, furosemide and glucocorticoids without significant improvement, but became eucalcemic within 24 hours after receiving a single dose of pamidronate. This case highlights the potential danger of high dose vitamin supplements in children, and the salutary effects of treatment with bisphosphonate.
Chatterjee
Manjula
M
Division of Pediatric Endocrinology, Schneider Children's Hospital, New Hyde Park, NY 11040, USA. Mchatter@nshs.edu
Speiser
Phyllis W
PW
D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood; D004164:Diphosphonates / Q000627:therapeutic use*; D062787:Drug Overdose; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy*; D007223:Infant; D008297:Male; D000077268:Pamidronate; D016896:Treatment Outcome; D014807:Vitamin D / Q000009:adverse effects*
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D014807:Vitamin D; D000077268:Pamidronate; D002118:Calcium