The Importance of Dietary Therapy in Acute Vitamin D Intoxication

A previously healthy 9-month-old girl was brought to our clinic after falling from a height. She was restless and mildly dehydrated. She had been given 300,000 units of vitamin D in the previous 10 days. The levels of serum calcium, 25(OH) D vitamin, and parathyroid hormone were 17.1 mg/dl [reference 8.0-10.2], 892.9 ng/ml [reference 7.4-53.3], and 9.8 pg/mL [reference 9-65], respectively. She was treated with intravenous fluids, furosemide, calcitonin, steroid, and a diet containing minimal amounts of calcium and vitamin D. The daily dietary intake was 148 mg calcium and 8 units of vitamin D. Thirty-five days later, the serum vitamin D level had returned to a safe level. The effect of vitamin D can last for months, since it is fat-soluble. The recommended drug therapy inhibits calcium absorption. A diet with reduced calcium and vitamin D shortens the duration of therapy. This article emphasizes the importance of dietary treatment.