A rare case of hypercalcemia induced by high doses of Vitamin D, finds study
In a recent research paper, researchers have put forth a case of hypervitaminosis D-induced altered mental status where diagnosis was delayed and additional invasive testing was performed due to an assumption regarding phosphatemia.
The interesting findings have been published in Clinical Nephrology Case Studies.
Hypercalcemia is broadly divided into parathyroid hormone (PTH)-mediated, vitamin D-mediated, and non-humoral etiologies . Classic symptoms of hypercalcemia include altered mental status, constipation, shortened QT interval, muscle weakness, nephrolithiasis, and renal failure . Hypervitaminosis D is an uncommon cause of hypercalcemia, but the use of vitamin D supplementation has expanded and case reports of supplemental vitamin D induced hypercalcemia have become more frequent.
In the recent report, researchers reported a 64-year-old man with a history of chronic obstructive pulmonary disease and ethanol abuse use presented to the emergency department with altered mentation.
Physical exam revealed bilateral upper extremity tremors and obtundation. Lab investigations confirmed hypercalcemia with appropriately suppressed iPTH and low PTHrP resulted in an evaluation for hypervitaminosis D. The patient had an elevated vitamin D 25OHD and normal calcitriol revealing the ultimate diagnosis to be hypervitaminosis D.
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