Vitamin D toxicity resulting from overzealous correction of vitamin D deficiency. (14th July 2015)

• Record Type: Journal Article
• Authors: Kaur, Parjeet; Mishra, Sunil Kumar; Mithal, Ambrish
• Is Part Of: Clinical endocrinology. Volume 83:Number 3(2015:Sep.)
• Page Start: 327
• Page End: 331
• Publication Date: 2015-07-14
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.12836
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" id="cen12836-abs-0001"> <title>Summary</title> <sec id="cen12836-sec-0001" sec-type="section"> <title>Background</title> <p>Vitamin D toxicity, often considered rare, can be life‐threatening and associated with substantial morbidity, if not identified promptly.</p> </sec> <sec id="cen12836-sec-0002" sec-type="section"> <title>Objective</title> <p>To describe clinical and biochemical features, risk factors and management of patients with vitamin D toxicity seen between January 2011 and January 2013.</p> </sec> <sec id="cen12836-sec-0003" sec-type="section"> <title>Methodology</title> <p>Patients presenting with vitamin D toxicity, between January 2011 and January 2013, at single tertiary care centre in Delhi‐NCR, India, were included. Evaluation included detailed clinical history and biochemical tests including serum calcium, phosphorus, creatinine, intact parathyroid hormone and 25‐hydroxyvitamin D (25(OH)D).</p> </sec> <sec id="cen12836-sec-0004" sec-type="section"> <title>Results</title> <p>Sixteen patients with vitamin D toxicity could be identified. Clinical manifestations included nausea, vomiting, altered sensorium, constipation, pancreatitis, acute kidney injury and weight loss. Median (range) age was 64·5 (42–86) years. Median (range) serum 25(OH)D level and median (range) serum total serum calcium level were 371 (175–1161) ng/ml and 13·0 (11·1–15·7) mg/dl, respectively. Overdose of vitamin D caused by prescription of mega‐doses of vitamin D was the cause of vitamin D toxicity in all cases. Median (range) cumulative vitamin D dose was 3 600 000 (2 220 000–6 360 000) IU.</p> </sec> <sec id="cen12836-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Our data demonstrate an emergence of vitamin D toxicity as an increasingly common cause of symptomatic hypercalcaemia. Irrational use of vitamin D in mega‐doses resulted in vitamin D toxicity in all cases. Awareness among healthcare providers regarding the toxic potential of high doses of vitamin D and cautious use of vitamin D supplements is the key to prevent this condition.</p> </sec> </abstract>