Intoxication With Vitamin D

Calcinosis and Metastatic Calcification due to Vitamin D Intoxication

“…Reversibility of these ophthalmic lesions has been de scribed with treatment [2,31]; however, this was not the case with our patient. Whether these lesions are reversible may be related to the duration of exposure to vitamin D which was quite long in our patient compared with those cases in which the eye lesions have resolved.…”

“…anemia [1-3, 10, 13] and inability to concentrate urine [1][2][3]. All of these were present in the patient described in this report.…”

“…Other consequences of renal insufficiency described in hypervitaminosis D include azotemia [2,8,10,13], albu minuria [1][2][3], hypertension [2,30]. anemia [1-3, 10, 13] and inability to concentrate urine [1][2][3].…”

“…Both corneal and conjunctival calcifications have been described in vitamin D intoxication [2,13,31 ] and should be looked for by slitlamp examination in such patients. Reversibility of these ophthalmic lesions has been de scribed with treatment [2,31]; however, this was not the case with our patient.…”

“…Glucocorticoids were first used to treat hyper calcemia associated with sarcoidosis in 1953 [37] and vitamin D intoxication in 1958 [38]. Glucocorticoids decrease intestinal absorption of calcium [39] and de crease bone resorption [40] and should take less than I week to normalize the serum calcium in patients with hypervitaminosis D. Before the availability of glucocorti coids to treat vitamin-D-intoxicated states, the average time to normalize serum calcium was 2-4 months but sometimes greater than 14 months [2], Other modalities used to treat hypercalcemia associ ated with hypervitaminosis D include: mithramycin [8], calcitonin [8,41], both inhibitors of osteoclast function; sodium cellulose phosphate [42] which increases fecal calcium excretion; phénobarbital [43], phenytoin [43] and glutethimide [44] which induce hepatic microso-mal enzmes and therefore accelerate vitamin D metab olism.…”