From Rickets Prevention to Vitamin D Intoxication

Yıl 2014, Cilt: 11 Sayı: 3, - , 01.09.2014

Momcilo Pavlovic Karolina Berenji

https://doi.org/10.15197/sabad.1.11.71

Öz

Hypervitaminosis D occurs in infants due to increased intake of vitamin D and results in hypercalcemia and hypercalciuria. We present the case of a 4.5-month old infant with signs of vitamin D intoxication, which occurred due to supplementation for the purpose of rickets prevention and diet with vitamin D-fortified milk. The clinical manifestations were constipation, vomiting and failure to thrive. After excluding hormonal, tumoral and malformative (Williams syndrome) causes, treatment included hyperhydration, loop diuretics and prednisone. This case highlights the need for proper informing of parents on the manners of vitamin D supplementation during the first year of life in order to avoid dangers of parental dosing errors.

Anahtar Kelimeler

Vitamin D intoxication, hypercalcemia, Williams syndrome, prednisone

From Rickets Prevention to Vitamin D Intoxication

Öz

İnfantlarda D vitamin fazlalığı artmış vitamin D alımı neticesinde olur ve hiperkalsemi ve hiperkalsiüri ile sonuçlanır. Biz, vitamin D intoksikasyonu bulguları olan 4.5 aylık bir infant vakası sunuyoruz. Bu vakada vitamin D fazlalığı, riketsden korumak amacıyla diyette vitamin D ile takviye edilmiş süt kullanılması ile oluşmuştu. Klinik belirtiler kabızlık, kusma ve gelişme geriliğiydi. Hormonal, tümöral ve malformatif (Williams syndrome) sebepler dışlandıktan sonra,hiperhidrasyon, loop diüretikleri ve prednison ile tedavi edildi. Sunulan vaka, parenteral doz hatalarının tehlikelerini önlemek için yaşamın ilk yılında vitamin D suplementasyon metodları hakkında ebeveynlerin bilgilendirilmesinin ne kadar önemli olduğunu göstermektedir

Anahtar Kelimeler

Vitamin D zehirlenmesi, hiperkalsemi, Williams sendromu, prednizon

Kaynakça

• Radlovic N, Mladenovic M, Simic D, Radlovic P. Vitamin D in the light of current knowledge. Srp Arh Celok Lek 2012; 140: 110-4.
• Greenbaum L. Riskets and hypervitaminosis D. In: Kliegman RM, Stanton BF, St. Geme JW, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders 2011: 200-11.
• Wagner CL, Greer FR; American Academy of Pediatrics Section on Breastfeeding; American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vita- min D deficiency in infants, children, and adolescents. Pediatrics 2008; 122: 1142-52.
• Chesney RW. Vitamin D: Can an upper limit be defined? J Nutr 1989; 119: 1825-8.
• Blank S, Scanlon KS, Sinks TH, Lett S, Falk H. An outbreak of hypervitaminosis D associated with the over fortifi- cation of milk from a home-delivery dairy. Am J Public Health 1995; 85: 656-9.
• Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for calcium and vitamin D. Washington, DC: National Academy Press, 2010.
• Joshi R. Hypercalcemia due to hypervitaminosis D: report of seven patients. J Trop Pediatr 2009; 55: 396-8.
• Orbak Z, Doneray H, Keskin F, Turgut A, Alp H, Karakelleoglu C. Vitamin D intoxication and therapy with alendronate (case report and review of literature). Eur J Pediatr 2006; 165: 583–4.
• Chambellan-Tison C, Horen B, Plat-Wilson G, Moulin P, Claudet I. Severe hypercalcemia due to vitamin D intoxi- cation. Arch Pediatr 2007; 14: 1328-32.