title: Vitamin D and Risk for Vitamin A Intoxication in an 18-Month-Old Boy.
abstract: 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).
authors.affiliation: Department of Pediatrics, "Pugliese-Ciaccio" Hospital, 88100 Catanzaro, Italy.
authors.forename: Valentina
authors.identifier: 0000-0001-9027-6921
authors.initials: V
authors.lastname: Talarico
authors.affiliation: Department of Pediatrics, "Pugliese-Ciaccio" Hospital, 88100 Catanzaro, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Barreca
authors.affiliation: Department of Neonatology, "Pugliese-Ciaccio" Hospital, 88100 Catanzaro, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Galiano
authors.affiliation: Department of Pediatric Oncology and Hematology, "Pugliese-Ciaccio" Hospital, 88100 Catanzaro, Italy.
authors.forename: Maria Concetta
authors.initials: MC
authors.lastname: Galati
authors.affiliation: Department of Pediatrics, "Pugliese-Ciaccio" Hospital, 88100 Catanzaro, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Raiola