A six-month-old girl was brought to us with fever for one day and one episode of generalized seizure. There was no history of cough, rash, ear discharge, polyuria, polydypsia, constipation, nausea, vomiting or similar such episode. She received two mega doses (600,000 IU each) of oral vitamin D in last two months. Blood counts, kidney function tests, urine examination, blood culture, CSF examination and ultrasonography of the abdomen were normal. Serum levels of 25-OH Vitamin D3 were high (>160 ng/mL) with a normal serum calcium (10.1 mg/dL) and normal serum parathyroid hormone (46 pg/mL). We incidentally sent her serum lipid profile, which revealed high triglycerides (403 mg/dL), normal total cholesterol (123 mg/dL), and high VLDL cholesterol (81 mg/dL). The lipid profile of parents and other siblings were within normal limits. Secondary causes of hyperlipidemia were ruled out.

TABLE I  Lipid  Profile  of  the  Patient

Vitamin D receptors are found ubiquitously, including in adipose tissue, and 25(OH)D plays an important role in lipid metabolism via several mechanisms, including induction of an increase in lipoprotein lipase activity [3], increased lipogenesis and lipolysis, and enhanced intestinal calcium absorption, which could reduce the formation of calcium fatty soaps in the gut and increase the absorption of fat. In a recent report [4], cholesterol and triglyceride levels were found to be increased in an adolescent following vitamin D treatment. Similar findings in adults have been reported earlier [5].

5. Wang H, Xia N, Yang Y, Peng DQ. Influence of vitamin D supplementation on plasma lipid profiles: A meta-analysis of randomized controlled trials. Lipids Health Dis. 2012;11:42.