title: Acute vitamin D intoxication possibly due to faulty production of a multivitamin preparation.
abstract: Vitamin D intoxication usually occurs as a result of inappropriate use of vitamin D preparations and can lead to life-threatening hypercalcemia. It is also known that there are a number of physicians who prescribe vitamin D supplements for various clinical conditions, such as poor appetite and failure to thrive. While inappropriate use of vitamin D supplements may lead to vitamin D intoxication, there are no reports of cases of vitamin D toxicity due to manufacturing errors of vitamin D preparations. Here, we present cases of hypervitaminosis D which developed following the use of a standard dose of a multivitamin preparation. All three cases presented with hypercalcemia symptoms and had characteristic laboratory findings such as hypercalcemia, hypercalciuria, low levels of parathyroid hormone. The very high serum 25(OH) vitamin D levels in these patients indicated vitamin D excess. The vitamin D level of the prescribed multivitamin preparation in the market was studied and was found to contain a very low level of vitamin D (10 IU/5 mL). Although the stated vitamin D content of the preparations ingested by these patients was not high, unproven but possible manufacturing errors were considered to be a possible cause of the hypervitaminosis D diagnosed in these three patients.
authors.affiliation: Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Anık
authors.forename: Gönül
authors.initials: G
authors.lastname: Çatlı
authors.forename: Ayhan
authors.initials: A
authors.lastname: Abacı
authors.forename: Ceyhun
authors.initials: C
authors.lastname: Dizdarer
authors.forename: Ece
authors.initials: E
authors.lastname: Böber
mesh_terms: D002118:Calcium / Q000097:blood; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004339:Drug Compounding / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000139:chemically induced; D053565:Hypercalciuria / Q000097:blood / Q000139:chemically induced; D007223:Infant; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D014807:Vitamin D / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D014815:Vitamins / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D010281:Parathyroid Hormone; D014815:Vitamins; D014807:Vitamin D; D002118:Calcium