Three Cases of Hypercalcemia Due to Vitamin D Intoxication in Infancy

Choi, Jin Ho; Yum, Mi Sun; Hahn, Hyewon; Park, Young Seo

Abstract

Hypercalcemia in infancy is an uncommon disorder but has a potential of serious sequelae. Therefore, infants with hypercalcemia must be promptly investigated and need urgent management. We report three cases of infantile hypercalcemia caused by vitamin D intoxication, emphasizing diagnostic investigations and the course of treatment. The first and the second cases were thought to be vitamin D intoxication without doubt, and were presented with a low parathyoid hormone(PTH) level and increased 25-hydroxyvitamin D3(25(OH)D3). The third case, which was hypotonic and accompanied with chromosomal anomaly, showed relatively low PTH and elevated 25(OH)D3. The first and the third case presented with poor oral intake and a failure to thrive. The second case was asymptomatic and founded incidentally by routine laboratory tests during treatment of the underlying disease. The hypercalcemia of three patients improved after a change of the formula milk with short term medication, lowering serum calcium. Thus we suspect that infants with hypercalcemia have a vitamin D intoxication caused by formula milk. This report describes three cases of hypercalcemia in infancy induced by vitamin D intoxication, a with review of the literature.