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

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. © journal of clinical research in pediatric endocrinology,published by galenos publishing.