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Prolonged vitamin D intoxication: presentation, pathogenesis and progress.

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Internal Medicine Journal
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Summary
This summary is machine-generated.

Vitamin D toxicity from unactivated vitamin D (calciferol) therapy is rare but may increase with high-dose preparations. This toxicity can cause reversible hypercalcaemia and kidney issues, with parathyroid hormone levels potentially remaining high.

Keywords:
acute renal injuryhypercalcaemiavitamin D intoxication

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Area of Science:

  • Endocrinology
  • Nephrology
  • Clinical Pharmacology

Background:

  • Unactivated vitamin D (calciferol) therapy is used for vitamin D deficiency.
  • High-dose preparations of unactivated vitamin D are becoming more accessible.
  • Vitamin D toxicity is a potential adverse effect of excessive supplementation.

Observation:

  • Vitamin D toxicity from unactivated vitamin D (calciferol) is a rare cause of hypercalcaemia.
  • The incidence of this toxicity may rise with increased availability of high-dose unactivated vitamin D.
  • Prolonged toxicity can lead to hypercalcaemia and renal impairment.

Findings:

  • Hypercalcaemia associated with vitamin D toxicity is often reversible.
  • Renal impairment resulting from vitamin D toxicity may be partially reversible.
  • Parathyroid hormone levels might not be suppressed in cases of unactivated vitamin D toxicity, particularly with coexisting renal disease.

Implications:

  • Clinicians should be aware of the potential for increased vitamin D toxicity with new high-dose formulations.
  • Monitoring calcium and renal function is crucial in patients receiving high-dose unactivated vitamin D.
  • The atypical suppression of parathyroid hormone in vitamin D toxicity warrants further investigation, especially in patients with kidney compromise.