title: Vitamin D intoxication in two brothers: be careful with dietary supplements.
abstract: Vitamin D (VitD) intoxication, a well-known cause of hypercalcaemia in children, has renal, cardiac and neurological consequences. Iatrogenic or accidental administrations are the most common causes. We present two cases of hypervitaminosis D due to over-the-counter VitD supplement self-medication. A 12-year-old boy was hospitalised for abdominal pain, constipation and vomiting. Routine biochemistry indicated severe hypercalcaemia and renal failure. Plasma 25-OH VitD level was very high and parathyroid hormone was suppressed. Renal ultrasound showed nephrolithiasis. Hydration, diuretics and prednisone induced a progressive reduction of calcium levels. His brother, who was receiving the same treatment, was hospitalised although asymptomatic. Normal serum calcium and renal function were revealed, while 25-OH VitD was high and parathyroid hormone was suppressed. Renal ultrasound was within the normal range. Examination of the VitD content of the over-the-counter supplement revealed a higher amount than declared. VitD administration implies several risks and must be prescribed only when needed and under strict medical control.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conti
authors.forename: Valeria
authors.initials: V
authors.lastname: Chirico
authors.forename: Antonio
authors.initials: A
authors.lastname: Lacquaniti
authors.forename: Lorena
authors.initials: L
authors.lastname: Silipigni
authors.forename: Claudia
authors.initials: C
authors.lastname: Fede
authors.forename: Agata
authors.initials: A
authors.lastname: Vitale
authors.forename: Carmelo
authors.initials: C
authors.lastname: Fede
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced; D000293:Adolescent; D002648:Child; D019587:Dietary Supplements / Q000009:adverse effects*; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced*; D008297:Male; D053040:Nephrolithiasis / Q000139:chemically induced; D010281:Parathyroid Hormone / Q000097:blood; D035781:Siblings; D014807:Vitamin D / Q000097:blood / Q000633:toxicity*
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D