1例女婴自1岁半起不规律服用家长自行在药店购买的维生素D2片(0.25 mg/片,每片含10 000 IU维生素D2,每次1片,每日1~3次,偶尔漏服).5个月后,出现多饮、多尿症状,每日饮水量大于2000 ml,0.5~1 h排尿1次,夜间排尿>5次,尿量最多时可达3 400 ml/d,尿色透明如清水样.症状出现3周后在外院实验室检查示血钙4.34 mmol/L,血磷2.65 mmol/L,24 h尿钙8.0 mmol,怀疑维生素D中毒,嘱家长停用维生素D2片,给予补液、利尿等治疗,3d后血钙降至3.60 mmol/L.6d后转入北京大学第一医院,继续给予补液及对症治疗,低钙低磷饮食.8d后复查,血钙2.47 mmol/L,24h尿钙2.7 mmol,患儿多饮、多尿症状改善,好转出院.出院后1个月电话随访,患儿多饮、多尿症状消失,尿常规正常.
A young girls took irregularly Vitamin D2 tablets (0.25 mg/tablet,each tablet contains 10 000 IU vitamin D2) purchased by her parents at a pharmacy since she was 1.5 years old.The girl took 1 tablet at a time,once to thrice daily,occasionally missing.Five months later,she developed polydipsia and polyuria.She drank more than 2 000 ml water every day,urinated once every 0.5-1 hour,and urinated more than 5 times every night.Her maximum daily urine volume could reach 3 400 ml,and her urine was transparent as clear water.Three weeks after the symptoms appeared,laboratory tests in another hospital showed that blood calcium was 4.34 mmol/L,blood phosphorus was 2.65 mmol/L,and 24-hours urine calcium was 8.0 mmol.Vitamin D poisoning was suspected and her parents were asked to stop feeding the girl vitamin D2 tablets.Rehydration,diuretics and other treatments were given.After 3 days,her blood calcium decreased to 3.60 mmol/L.After 6 days,she was transferred to Peking University First Hospital,where she continued to receive rehydration and symptomatic treatments with a low calcium and phosphorus diet.And after 8 days,the blood calcium was 2.47 mmol/L and 24-hours urine calcium was 2.7 mmol.Her symptoms of polydipsia and polyuria improved and she was discharged.Telephone follow-up 1 month after discharge,the girl's polydipsia and polyuria disappeared and her urine examination was normal.