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Journal of Tropical Pediatrics Advance Access published online on April 1, 2009
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmp020
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© The Author [2009]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Brief Report

Hypercalcemia due to Hypervitaminosis D: Report of Seven Patients

Rajesh Joshi

Department of Pediatrics, B. J. Wadia Hospital for Children, Parel, Mumbai, Maharashtra, India

Correspondence: Rajesh Joshi, C/2, Om Parshwanath Apts, Saibaba Nagar, Borivali (West), Mumbai-400092, Maharashtra, India.


  Abstract

We retrospectively studied seven children (six girls, one boy) aged from 7.5 to 25 months who presented to our institution after taking large doses of vitamin D (900 000–4 000 000 U) prescribed by medical practitioners for wrong indications like failure to thrive, etc. The clinical manifestations were constipation, decreased appetite, lethargy, polyuria, dehydration and failure to thrive. All patients had hypercalcemia (serum calcium ranging from 12 to 16.8 mg/dl), high 25[OH]D levels (ranging from 96 to >150 ng/ml), suppressed intact parathyroid hormone (ranging from <3 to 8.1 pg/ml). Hypercalciuria (urinary calcium/creatinine ranging from 1 to 2.45) was found in all patients, while nephrocalcinosis was present in five patients. All were treated with intravenous fluids, oral prednisolone, restriction of calcium in diet, while four patients received pamidronate infusion for reducing hypercalcemia.

Key Words: vitamin D • hypercalcemia • hypervitaminosis


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