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What is vitamin D intoxication and how does it present?

waelhammad
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2022-11-19
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A 54-year-old female presents with drowsiness to the emergency. Her BP is 140/90 mm of Hg with pulse after rate 100/minute. Her investigations reveals serum creatinine 2.4 mg/dL, Na 140 mEq/L, K 4.3 mEq/L. Complete blood count (CBC) and liver function test (LFT) is normal. CT scan head is normal. Her past evaluation reveals a cervical lymph node fine needle aspiration cytology (FNAC) suggestive of granulomatous inflammation. Her bone marrow examination is suggestive of non-Hodgkin’s lymphoma.

What is vitamin D intoxication and how does it present?

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waelhammad
2022-11-19
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It is due to excessive biologic actions of elevated levels of 25(OH)D. Diagnosis is by 25(OH)D levels >100 ng/mL. It is increasingly been seen with unregulated overuse of vitamin D in therapeutic doses without measuring blood levels. 1,25(OH)2D levels may not be elevated (because they are tightly regulated). Treatment is to stop intake of vitamin D. Maintaining adequate hydration and Hydrocortisone 100 mg/day may be helpful. Hypercalcemia may persist for weeks as vitamin D stores in fat may be substantial.

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