Question: Vitamin D intoxication is an uncommon problem for pediatric aged patients. What is the clinical presentation of children suffering from hypervitaminosis D?
Answer: The cited reference reports: “Children with vitamin D intoxication present with symptoms of hypercalcemia, such as poor appetite, weight loss, abdominal pain, vomiting, constipation, polyuria, and polydipsia, and in severe cases, life-threatening dehydration. Because the complaints of hypercalcemia are nonspecific, symptoms can be present for prolonged periods before a child worsens and comes to medical attention. In some cases, the concentration of calcium in the glomerular filtrate may exceed its solubility, resulting in calcium precipitation in the renal tubules and nephrocalcinosis. This complication occurs in approximately 25% of patients with vitamin D intoxication, whereas in some pediatric series, vitamin D intoxication accounts for about 10% of all cases of nephrocalcinosis. Dehydration, decreased glomerular filtration rate, and nephrocalcinosis may all compromise renal function resulting in renal tubular acidosis and insufficiency. Metastatic vascular calcifications have also been reported.” (Vogiatzi MG et al. Vitamin D supplementation and risk of toxicity in pediatrics: A review of current literature. 2014 J Clin Endocrinol Metab 99: 1132–1141)