{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:51:17Z","timestamp":1790787077809,"version":"4.1.0"},"reference-count":10,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,10,21]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>Vitamin D is a fat-soluble vitamin synthesised in the skin through sunlight exposure and is routinely supplemented in infants due to its limited presence in human milk. The recommended dose is 400\u2009IU\/day until 1 year of age. However, excessive supplementation can result in hypervitaminosis D, a serious condition in infants. We report a case of a term male infant who presented with poor feeding and an irritable cry, especially during urination, for 3\u2009days. It was found that he had been receiving 6000\u2009IU\/day of vitamin D for 45 days, with a cumulative dose of 320\u2009000\u2009IU. Laboratory results revealed toxic vitamin D levels (&gt;120\u2009ng\/mL), elevated serum calcium and a high urine calcium\/creatinine ratio, though imaging showed no nephrocalcinosis. Supplementation was stopped and hyperhydration initiated, leading to symptomatic improvement within 48 hours. This case highlights the importance of cautious prescription practices to prevent supplement-related toxicity in children.<\/jats:p>","DOI":"10.1136\/bcr-2025-267253","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T02:05:16Z","timestamp":1763949916000},"page":"e267253","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Prescription\u2014dispensing mismatch leading to vitamin D intoxication in an infant"],"prefix":"10.1136","volume":"18","author":[{"given":"Aiswarya","family":"Sudarsan","sequence":"first","affiliation":[{"name":"Paediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, 123, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umapathy","family":"Pasupathy","sequence":"additional","affiliation":[{"name":"Paediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, 123, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umaserma","family":"Bharathi","sequence":"additional","affiliation":[{"name":"Paediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, 123, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,11,23]]},"reference":[{"key":"2025112318050435000_18.11.e267253.1","doi-asserted-by":"crossref","DOI":"10.1002\/ccr3.7635","article-title":"Vitamin D supplementation leading to hypervitaminosis D in a breastfed infant: A case report","volume":"11","author":"Twanabasu","year":"2023","journal-title":"Clin Case Rep"},{"key":"2025112318050435000_18.11.e267253.2","doi-asserted-by":"crossref","DOI":"10.3390\/toxics11070642","article-title":"Clinical Toxicology of Vitamin D in Pediatrics: A Review and Case Reports","volume":"11","author":"Levita","year":"2023","journal-title":"Toxics"},{"key":"2025112318050435000_18.11.e267253.3","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1007\/s13312-022-2448-y","article-title":"Indian Academy of Pediatrics Revised (2021) Guidelines on Prevention and Treatment of Vitamin D Deficiency and Rickets","volume":"59","author":"Gupta","year":"2022","journal-title":"Indian Pediatr"},{"key":"2025112318050435000_18.11.e267253.4","doi-asserted-by":"crossref","DOI":"10.1177\/2333794X17731695","article-title":"Vitamin D Toxicity in Young Breastfed Infants: Report of 2 Cases","volume":"4","author":"Bilbao","year":"2017","journal-title":"Glob Pediatr Health"},{"key":"2025112318050435000_18.11.e267253.5","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1997.02170400110025"},{"key":"2025112318050435000_18.11.e267253.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2009.03425.x"},{"key":"2025112318050435000_18.11.e267253.7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-0309"},{"key":"2025112318050435000_18.11.e267253.8","first-page":"65","article-title":"Medication errors: neonates, infants and children are the most vulnerable!","volume":"13","author":"Poole","year":"2008","journal-title":"J Pediatr Pharmacol Ther"},{"key":"2025112318050435000_18.11.e267253.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2009.03428.x"},{"key":"2025112318050435000_18.11.e267253.10","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2022.880928","article-title":"A Survey of Prescription Errors in Paediatric Outpatients in Multi-Primary Care Settings: The Implementation of an Electronic Pre-Prescription System","volume":"10","author":"Tan","year":"2022","journal-title":"Front Pediatr"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-267253","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T02:05:17Z","timestamp":1763949917000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-267253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":10,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,23]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1136\/bcr-2025-267253"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-267253","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}