Pediatric Vitamin D: Pseudo-Hypervitaminosis

Authors

Lily Olayinka
Izmarie Poventud-Fuentes
Emily Garnett
Sridevi Devaraj

Publication Date

7-1-2023

Journal

Journal of Clinical Laboratory Analysis

DOI

10.1002/jcla.24950

PMID

37526221

PMCID

PMC10492448

PubMedCentral® Posted Date

8-1-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Child, Chromatography, Liquid, Tandem Mass Spectrometry, Vitamin D, Calcifediol, Vitamins, Immunoassay, 25-Hydroxyvitamin D 2, 25‐hydroxyvitamin D, architect i2000SR, immunoassays, liquid chromatography–tandem mass spectrometry, vitamin D assays

Abstract

BACKGROUND: Vitamin D toxicity is rare in pediatric population. Falsely elevated levels of 25-hydroxyvitamin D have been reported as a major challenge with immunoassay methods for quantifying vitamin D metabolites.

CASE PRESENTATION AND METHOD: Here, we present two pediatric cases of falsely elevated 25-hydroxyvitamin D that resulted in unnecessary further testing. We also report significant same-day variation in the measurement of 25-hydroxyvitamin D using the Abbott i2000SR immunoassay. Samples were spun twice and their values were confirmed with the gold standard liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for confirmation.

CONCLUSION: The addition of a centrifugation step prior to sample testing resolved the variation observed in the measurement of 25-hydroxyvitamin D levels. The patient samples were confirmed with instruments from a different vendor and LC-MS/MS. Re-centrifugation of samples resolved the variation in the 25-hydroxyvitamin D values.