Biomaterial Database

[Vitamin A poisoning revealed by hypercalcemia in a child with kidney failure]. 1996

V Doireau, and M A Macher, and P Brun, and O Bernard, and C Loirat

Service de néphrologie, hôpital Robert-Debré, Paris, France.

BACKGROUND Patients with chronic renal failure are at risk of vitamin A intoxication, a risk that must be evoked when unexplained hypercalcemia occurs. METHODS An 8 year-old boy with Alagille syndrome and chronic renal failure was admitted because of general deterioration, and bone pain. Severe hypercalcemia (3.9 mmol/L) was present. Serum phosphate, parathyroid hormone and 25 OH D3 levels were normal; 1-25 (OH)2 D3 levels were undetectable. Hypercalcemia was attributed to vitamin A intoxication, due to the administration of a mean daily dose of 12000 IU of vitamin A for at least 2 years. The diagnosis was confirmed by high plasma levels of retinol (1475 micrograms/L). Hypercalcemia only partially responded to treatment with bisphosphonates, calcitonin and dialysis with low calcium dialysate. Serum vitamin A levels remained elevated one month after vitamin A withdrawal. The boy died two months after admission from atrioventricular block. CONCLUSIONS Vitamin A administration induces a high risk of intoxication in patients with chronic renal failure. Serum vitamin A concentrations are elevated in these patients, because of decreased renal metabolism of retinol, and vitamin A supplements must be avoided.

UI	MeSH Term	Description	Entries
D006986	Hypervitaminosis A	A symptom complex resulting from ingesting excessive amounts of VITAMIN A.
D007676	Kidney Failure, Chronic	The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.	ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008297	Male		Males
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006934	Hypercalcemia	Abnormally high level of calcium in the blood.	Milk-Alkali Syndrome,Hypercalcemias,Milk Alkali Syndrome,Syndrome, Milk-Alkali
D016738	Alagille Syndrome	A multisystem disorder that is characterized by aplasia of intrahepatic bile ducts (BILE DUCTS, INTRAHEPATIC), and malformations in the cardiovascular system, the eyes, the vertebral column, and the facies. Major clinical features include JAUNDICE, and congenital heart disease with peripheral PULMONARY STENOSIS. Alagille syndrome may result from heterogeneous gene mutations, including mutations in JAG1 on CHROMOSOME 20 (Type 1) and NOTCH2 on CHROMOSOME 1 (Type 2).	Arteriohepatic Dysplasia,Dysplasia, Arteriohepatic,Alagille Syndrome 1,Alagille Syndrome 2,Alagille Watson Syndrome,Alagille's Syndrome,Alagille-Watson Syndrome,Arteriohepatic Dysplasia (AHD),Cardiovertebral Syndrome,Cholestasis with Peripheral Pulmonary Stenosis,Hepatic Ductular Hypoplasia,Hepatic Ductular Hypoplasia, Syndromatic,Hepatofacioneurocardiovertebral Syndrome,Paucity of Interlobular Bile Ducts,Watson Alagille Syndrome,Watson Miller Syndrome,Watson-Miller syndrome,Alagilles Syndrome,Ductular Hypoplasia, Hepatic,Dysplasia, Arteriohepatic (AHD),Hypoplasia, Hepatic Ductular,Syndrome, Alagille,Syndrome, Alagille Watson,Syndrome, Alagille's,Syndrome, Alagille-Watson,Syndrome, Cardiovertebral,Syndrome, Hepatofacioneurocardiovertebral,Syndrome, Watson Alagille,Syndrome, Watson Miller,syndrome, Watson-Miller