Vitamin-D

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Vitamin-D Hypercalcaemia secondary to drug intoxication: case report

A 25-year-old woman developed hypercalcaemia secondary to drug intoxication while receiving vitamin-D for presumed vitaminD deficiency. The woman, who had familial hypercholesterolemia, type I diabetes mellitus (DM), lypodystrophy and scoliosis, presented with pain in multiple joints. She reported to have experienced morning stiffness and pain in the hands, wrists, forearms, ankles, and knees, which had lasted longer than 15–20 minutes for 4 years. Metacarpophalangeal, metatarsophalangeal and proximal interphalangeal joints were painful when squeezed. A wrist radiography revealed widespread atypical cystic changes. Further, an MRI revealed metabolic disease leading to multiple bone involvement and brown tumours. Abdominal ultrasonography showed nephrolithiasis, grade II hepatosteatosis and hepatomegaly. Her calcium level was high, parathormone level was low, phosphorous was normal and vitamin-D levels [25(OH)D3] were 10.3 ng/mL. Anamnesis revealed she had been receiving vitamin-D [dosage and route not stated] since the past 6 months. However, there was no aetiology for her underlying hypercalcaemia. Therefore, a repeat vitamin-D measurement was carried out and it was noted that the specimen was too lipaemic, and hence, it showed false measurements of vitamin-D deficiency. Her actual vitamin-D levels were found to be 188 ng/mL and 186 ng/mL in the two subsequent tests, indicating vitamin-D intoxication. Her nephrolithiasis was attributed to the hypercalcaemia secondary to vitaminD intoxication [time to reaction onset not stated]. The woman’s vitamin-D therapy was stopped, and hydration was recommended. Later, she was redirected to a genetic clinic for her comorbidities [outcome not stated]. Gonel A, et al. False Negative D Vitamin Measurement in LC-MS/MS Method Due to Hyperlipidemia: Case Report. Combinatorial Chemistry and High Throughput Screening 22: 428-430, No. 6, 2019. Available from: URL: http://doi.org/10.2174/1386207322666190722155106

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Reactions 26 Sep 2020 No. 1823

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