{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T01:23:52Z","timestamp":1779931432968,"version":"3.53.1"},"reference-count":9,"publisher":"Walter de Gruyter GmbH","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2020-0075_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Vitamin A is essential for normal cellular physiology and is often taken as a dietary supplement. Hypervitaminosis A can lead to hypercalcemia by increasing osteoclasts and subsequent bone resporption. Dietary supplements including vitamin A are new popular treatment stategies for autism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0075_abs_002\">\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>We report a five-year old boy with autism spectrum disorder presenting with severe abdominal pain and bilateral lower extremity pain, who was found to have persistent hypercalcemia due to hypervitaminosis A. The patient ingested over 700 times the recommended intake of Vitamin A per day for age. Retention of vitamin A in the liver and adipose tissue causes toxic levels of retinoids and hypercalcemia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0075_abs_003\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Acute treatment included intravenous rehydration, furosemide, and calcitonin. Pamidronate was the definitive treatment for hypercalcemia from hypervitaminosis A due to its osteoclast inhibition and long biologic half-life. Parents should be counseled on risks of toxicity and absence of evidence showing benefits of vitamin A therapy for autism.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2020-0075","type":"journal-article","created":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T16:43:22Z","timestamp":1594745002000},"page":"1111-1115","source":"Crossref","is-referenced-by-count":7,"title":["Hypercalcemia from hypervitaminosis A in a child with autism"],"prefix":"10.1515","volume":"33","author":[{"given":"Shannon","family":"O\u2019Neal","sequence":"first","affiliation":[{"name":"Department of Pediatrics , College of Medicine, University of Florida , Gainesville , FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy P.","family":"Foster","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , College of Medicine, University of Florida , Gainesville , FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avni","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , College of Medicine, University of Florida , Gainesville , FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele N.","family":"Lossius","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , College of Medicine, University of Florida , Gainesville , FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Dayton","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , College of Medicine, University of Florida , Gainesville , FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2020,7,13]]},"reference":[{"key":"2021082202005789997_j_jpem-2020-0075_ref_001","doi-asserted-by":"crossref","unstructured":"Conaway, HH, Henning, P, Lerner, UH. Vitamin a metabolism, action, and role in skeletal homeostasis. Endocr Rev 2013;34:766\u201397. https:\/\/doi.org\/10.1210\/er.2012-1071.","DOI":"10.1210\/er.2012-1071"},{"key":"2021082202005789997_j_jpem-2020-0075_ref_002","doi-asserted-by":"crossref","unstructured":"Binkley, N, Krueger, D. Hypervitaminosis A and bone. Nutr Rev 2000;58:138\u201344. https:\/\/doi.org\/10.1111\/j.1753-4887.2000.tb01848.x.","DOI":"10.1111\/j.1753-4887.2000.tb01848.x"},{"key":"2021082202005789997_j_jpem-2020-0075_ref_003","doi-asserted-by":"crossref","unstructured":"Vyas, AK, White, NH. Case of hypercalcemia secondary to hypervitaminosis A in a 6-year-old boy with autism. Case Rep Endocrinol 2011. [Internet]. 2011 [cited 2018 Oct 25]. Available from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3420388\/.","DOI":"10.1155\/2011\/424712"},{"key":"2021082202005789997_j_jpem-2020-0075_ref_004","doi-asserted-by":"crossref","unstructured":"Kimmoun, A, Leheup, B, Feillet, F, Dubois, F, Morali, A. Hypercalcemia revealing iatrogenic hypervitaminosis A in a child with autistic troubles. Arch Pediatr Organe Off Soc Francaise Pediatr 2008;15:29\u201332. https:\/\/doi.org\/10.1016\/j.arcped.2007.09.012.","DOI":"10.1016\/j.arcped.2007.09.012"},{"key":"2021082202005789997_j_jpem-2020-0075_ref_005","unstructured":"Institute of Medicine (US) Panel on Micronutrients. Dietary reference intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc [Internet]. Washington (DC): National Academies Press (US); 2001 [cited 2019 Feb 1]. Available from: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK222310\/."},{"key":"2021082202005789997_j_jpem-2020-0075_ref_006","doi-asserted-by":"crossref","unstructured":"Green, AC, Martin, TJ, Purton, LE. The role of vitamin A and retinoic acid receptor signaling in post-natal maintenance of bone. J Steroid Biochem Mol Biol 2016;155:135\u201346. https:\/\/doi.org\/10.1016\/j.jsbmb.2015.09.036.","DOI":"10.1016\/j.jsbmb.2015.09.036"},{"key":"2021082202005789997_j_jpem-2020-0075_ref_007","doi-asserted-by":"crossref","unstructured":"O\u2019Brien, CA. Control of RANKL gene expression. Bone 2010;46:911\u20139. https:\/\/doi.org\/10.1016\/j.bone.2009.08.050.","DOI":"10.1016\/j.bone.2009.08.050"},{"key":"2021082202005789997_j_jpem-2020-0075_ref_008","doi-asserted-by":"crossref","unstructured":"Christakos, S, Dhawan, P, Porta, A, Mady, LJ, Seth, T. Vitamin D and intestinal calcium absorption. Mol Cell Endocrinol 2011;347:25\u20139. https:\/\/doi.org\/10.1016\/j.mce.2011.05.038.","DOI":"10.1016\/j.mce.2011.05.038"},{"key":"2021082202005789997_j_jpem-2020-0075_ref_009","doi-asserted-by":"crossref","unstructured":"Guo, M, Zhu, J, Yang, T, Lai, X, Liu, X, Liu, J, et al. Vitamin A improves the symptoms of autism spectrum disorders and decreases 5-hydroxytryptamine (5-HT): a pilot study. Brain Res Bull 2018;137:35\u201340. https:\/\/doi.org\/10.1016\/j.brainresbull.2017.11.001.","DOI":"10.1016\/j.brainresbull.2017.11.001"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyter.com\/view\/journals\/jpem\/33\/8\/article-p1111.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2020-0075\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2020-0075\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,22]],"date-time":"2021-08-22T02:17:20Z","timestamp":1629598640000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyter.com\/document\/doi\/10.1515\/jpem-2020-0075\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,13]]},"references-count":9,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,7,13]]},"published-print":{"date-parts":[[2020,8,27]]}},"alternative-id":["10.1515\/jpem-2020-0075"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2020-0075","relation":{},"ISSN":["0334-018X","2191-0251"],"issn-type":[{"value":"0334-018X","type":"print"},{"value":"2191-0251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,13]]}}}