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Idiopathic infantile hypercalcemia: case report and review of the literature

  • Brynn E. Marks and Daniel A. Doyle ORCID logo EMAIL logo
Published/Copyright: October 24, 2015

Abstract

The widespread use of supplemental vitamin D has dramatically reduced the incidence of rickets. While generally considered a safe practice, there is potential for toxicity in patients with idiopathic infantile hypercalcemia (IIH). Inadequate 24-hydroxylase-enzyme activity renders these individuals unable to degrade active vitamin D, resulting in hypercalcemia due to increased intestinal calcium absorption, decreased renal calcium excretion, and increased osteoclastic bone activity. Clinicians should be aware that even therapeutic doses of vitamin D can prove harmful for patients with CYP24A1 mutations. Studies have also demonstrated a link between inadequate 24-hydroxylase activity and nephrocalcinosis, renal insufficiency, and calcium containing kidney stones, further emphasizing the importance of early recognition of this disease and judicious use of vitamin D. We present a case with an interesting diagnostic algorithm used to diagnose IIH when given an incomplete history and subsequently review the existing literature on the subject.


Corresponding author: Daniel A. Doyle, MD, Endocrinology Division Chief, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803, USA, Phone: +302-651-5965, Fax: +302-651-5419, E-mail: .

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Received: 2015-3-25
Accepted: 2015-8-27
Published Online: 2015-10-24
Published in Print: 2016-2-1

©2016 by De Gruyter

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