Table 4.
Case reports of infants with hypervitaminosis D due to daily ingestion of vitamin D
| Author | Patient | Vit D dose per day | Duration of vit D intake | Symptoms | Laboratory |
|---|---|---|---|---|---|
| Daily administration of vitamin D at doses up to 20times the AI | |||||
| Marie et al. (1969) | 8‐month‐old boy born at term, 3 months full formula‐fed, then start complementary feeding; anorexia | Birth to 4 months ‘normal’ vitamin D prophylaxis;At age 4 months, start 100 μg/dayAt age 6 months, 200 μg/day |
4 months 2 months 2 months |
Anorexia starting 1 month after increase of vitamin D dose, abnormal ECG (shortening QT interval), decreased glomerular filtration, X‐ray dense end metaphyseal bands |
Ca in serum 4.5 mmol/L Ca in urine 8 mg/kg per day |
| Chambellan‐Tison et al. (2007) | 4‐month‐old boy, breastfed, prescribed 30 μg vitamin D/day, received about 70 μg/day | 70 μg/day | 4 months | Since 2 weeks anorexia, hypotonia, weakness, constipation, polyuria, dehydration, neurological symptoms, nephrocalcinosis, abnormal ECG (prolonged QT interval) |
Ca in serum 4.28 mmol/L Ionised Ca 2.52 mmol/L (normal < 1.32) Ca in urine 3.6 mmol/kg per day Ca/Cr in urine 5.3 (unit not reported) (normal 0.5) 25(OH)D 800 nmol/LPTH ↓ |
| Ahmad and Al‐Agha (2013) | Premature (30 weeks, birth weight 950 g, hyaline membrane disease treated with TPN (4 weeks) | 2–5 months of age: 35 μg/day plus vit D from formula: 40–50 μg/day) (calculated) | 3 months |
5 months of age: Weight 2.2 kg < 5th centile, hypotonia, polyuria, hypernatraemia, nephrogenic diabetes insipidus, medullary nephrocalcinosis |
5 months of age: Ca in serum 2.95 mmol/L, Ca in urine 6.52 mmol/L, 25(OH)D 175 nmol/L, PTH ↓ Na 156 mmol/L, Cl 112 mmol/L, osmolality in serum 320, in urine 20 mosmol/kg |
| Radlovic et al. (2014) | 1.5‐month‐old girl. Full‐term healthy, birth weight 3,600 g, exclusively breastfed; received by misunderstanding 16 times prophylactic dose. At age 1.5 mo, length and weight 50th centile | From age 15 days to 45 days 167 μg vitamin D3/day | 1 month | No clinical symptoms |
1.5 month: Ca in serum 2.72 mmol/L 25(OH)D > 400 nmol/L PTH ↓ Ca/Cr in urine 1.6 mg/mg (normal < 0.8 mg/mg) |
| Pavlovic and Berenji (2014) | 4.5 months with weight loss (4.25 kg i.e < 3rd centile), Breastfed for 2.5 months, thereafter formula |
33 μg/day 44 μg/day |
From 2 weeks to 2.5 months of age (D2) = 8 weeks from 2.5 months of age plus 11 μg (D3) from formula = 8 weeks |
Vomiting, constipation |
Ca in serum 4.91 mmol/L, Ca/Cr in urine 2.81 (unit not reported) (normal < 0.2), 25(OH)D >375 nmol/L PTH ↓ |
25(OH)D: 25‐hydroxy‐vitamin D, Ca/Cr: calcium/creatinine ratio, ECG: electrocardiogram, PTH: parathyroid hormone.