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Vitamin D toxicity.

Debasish Maji¹

¹Department of Medicine, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India.

Indian Journal of Endocrinology and Metabolism

|April 4, 2012

Summary

A 67-year-old woman experienced confusion and lethargy due to extremely high vitamin D levels from excessive supplementation. Treatment normalized her calcium, and symptoms resolved with vitamin D and calcium restriction.

Area of Science:

Endocrinology
Clinical Biochemistry

Background:

Hypercalcemia can present with non-specific neurological and constitutional symptoms.
Vitamin D intoxication is a rare but serious condition requiring prompt diagnosis and management.

Observation:

A 67-year-old female presented with neurological and constitutional symptoms, initially attributed to unclear causes.
Investigations revealed hypercalcemia, and subsequent review of her medication history identified weekly high-dose vitamin D injections (Arachitol 6 lac units) for 3 months.

Findings:

The patient exhibited profoundly elevated serum 25-hydroxyvitamin D levels (254.70 ng/ml), confirming vitamin D toxicity.
Treatment with intravenous fluids, diuretics, and glucocorticoids, alongside dietary restrictions of calcium and vitamin D, normalized serum calcium levels.

Keywords:

Hypercalcemia injectable vitamin D vitamin D toxicity

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Implications:

This case highlights the critical importance of a thorough medication review in diagnosing unexplained hypercalcemia.
It underscores the potential for severe toxicity from excessive vitamin D supplementation, necessitating careful monitoring of treatment regimens.