Acute vitamin D intoxication possibly due to faulty production of a multivitamin preparation

J Clin Res Pediatr Endocrinol. 2013;5(2):136-9. doi: 10.4274/Jcrpe.896.

Abstract

Vitamin D intoxication usually occurs as a result of inappropriate use of vitamin D preparations and can lead to life-threatening hypercalcemia. It is also known that there are a number of physicians who prescribe vitamin D supplements for various clinical conditions, such as poor appetite and failure to thrive. While inappropriate use of vitamin D supplements may lead to vitamin D intoxication, there are no reports of cases of vitamin D toxicity due to manufacturing errors of vitamin D preparations. Here, we present cases of hypervitaminosis D which developed following the use of a standard dose of a multivitamin preparation. All three cases presented with hypercalcemia symptoms and had characteristic laboratory findings such as hypercalcemia, hypercalciuria, low levels of parathyroid hormone. The very high serum 25(OH) vitamin D levels in these patients indicated vitamin D excess. The vitamin D level of the prescribed multivitamin preparation in the market was studied and was found to contain a very low level of vitamin D (10 IU/5 mL). Although the stated vitamin D content of the preparations ingested by these patients was not high, unproven but possible manufacturing errors were considered to be a possible cause of the hypervitaminosis D diagnosed in these three patients.

Publication types

  • Case Reports

MeSH terms

  • Calcium / blood
  • Dietary Supplements*
  • Dose-Response Relationship, Drug
  • Drug Compounding / methods
  • Drug Compounding / standards
  • Female
  • Humans
  • Hypercalcemia / blood
  • Hypercalcemia / chemically induced
  • Hypercalciuria / blood
  • Hypercalciuria / chemically induced
  • Infant
  • Male
  • Parathyroid Hormone / blood
  • Vitamin D / administration & dosage
  • Vitamin D / adverse effects*
  • Vitamin D / blood
  • Vitamins / administration & dosage
  • Vitamins / adverse effects

Substances

  • Parathyroid Hormone
  • Vitamins
  • Vitamin D
  • Calcium