Medicine, George Washington University, Washington, DC, USA.
Medicine, George Washington University, Washington, DC, USA
BMJ Case Rep. 2020 Apr 29;13(4):e233853. doi: 10.1136/bcr-2019-233853.
Hypercalcaemia is a common diagnosis with the majority of cases resulting from hyperparathyroidism or malignancy. We report a rare case of persistent symptomatic hypervitaminosis D-induced hypercalcaemia in an individual taking 50 000 IU of vitamin D supplement daily for several months following a diagnosis of vitamin D deficiency. His hypercalcaemia was initially treated with calcitonin and intravenous fluids, but due to recurrent symptomatic hypercalcaemia after discharge, additional treatment with glucocorticoids and bisphosphonates was warranted during his second admission. The pathophysiology of hypercalcaemia from vitamin D intoxication results from the long-term effects of vitamin D storage in adipose tissue. In the present case, we discuss this pathophysiology and treatment approaches in the context of increasing awareness of and testing for vitamin D deficiency, and growing access to over-the-counter supplements.
高钙血症是一种常见的诊断，大多数病例是由甲状旁腺功能亢进症或恶性肿瘤引起的。我们报告了一个罕见的病例，一名患者在诊断出维生素 D 缺乏症后，每天服用 50000IU 的维生素 D 补充剂，持续数月后出现持续性症状性维生素 D 诱导的高钙血症。他的高钙血症最初用降钙素和静脉输液治疗，但由于出院后反复出现症状性高钙血症，在第二次入院期间需要用糖皮质激素和双膦酸盐进行额外治疗。维生素 D 中毒引起高钙血症的病理生理学是由于维生素 D 在脂肪组织中的长期储存作用。在本病例中，我们根据对维生素 D 缺乏症的认识和检测的提高，以及非处方补充剂的普及，讨论了这种病理生理学和治疗方法。
