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Updated: Apr 10, 2026

A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Undetectable serum calcidiol: not everything that glitters is gold
Gioconda Gallegos-Bayas1, José Francisco Pascual-Pareja2, Maria D Sanchez-Niño3
1Department of Family and Community Medicine, Centro de Salud Barrio del Pilar, Area 5, Madrid, Spain.
Abstract:
There is an increased awareness of the adverse consequences of nutritional vitamin D deficiency. We report a patient with chronic tophaceous gout, chronic kidney disease (CKD) Stage 3/4 and undetectable serum calcidiol who developed severe hypercalcaemia upon vitamin D supplementation despite serum 25(OH) vitamin D within the normal range. Upon recovery, serum 1,25(OH)2 vitamin D remained in the normal range despite CKD and serum 25(OH) vitamin D 6 ng/mL. Gout tophi biopsies from additional patients showed macrophage expression of 25(OH) vitamin D 1α-hydroxylase. This case illustrates the dangers of supplementing vitamin D in patients with low serum 25(OH) vitamin D and increased 1α-hydroxylase activity due to granulomatous disease.
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