Reactions 1402 - 19 May 2012

O SErgocalciferol overdose

Hypercalcaemia and nephrocalcinosis due tovitamin D2 intoxication following erroneousadministration in an infant: case report

A 6-month-old boy developed hypercalcaemia andnephrocalcinosis secondary to vitamin D2 intoxicationcaused by the erroneous administration of ergocalciferol.

The boy, who had been receiving 6 drops ofergocalciferol 6000IU daily [route and duration of therapynot stated], presented with weight loss, a state of declineand irritability, but no diarrhoea. On examination, he had amalnourished appearance. Blood tests revealedhaemoglobin 10.4 g/dL, haematocrit 29%, white blood cells12,560/µL and platelets 610,000/µL. He was admitted tothe Paediatric Intensive Care Unit.

The boy started continuous cardiorespiratory monitoringand food was discontinued. He received furosemide,methyprednisolone and bisphosphonates. He continued toshow signs of bilateral nephrocalcinosis 1 weeks afteradmission. His plasma 1,25-dihydroxyvitamin D level was140 pg/mL (48–120 pg/mL). His total blood calcium andionic levels eventually normalised.

Author comment: In this case the clinical symptomsalong with the high blood calcium levels led us to suspectpossible vitamin D intoxication... By administering 6 dropsdaily of vitamin D2, the infant was receiving 36,000 IU, whichis an amount 180 times above the recommended minimum.Lopez Azorin F, et al. Poisoning by overdose of vitamin d in an infant. Revista delLaboratorio Clinico 5: 49-53, No. 1, Jan 2012. Available from: URL: http://dx.doi.org/10.1016/j.labcli.2011.10.004 [Spanish; summarised from a translation] -Spain 803070574

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Reactions 19 May 2012 No. 14020114-9954/10/1402-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved